I have a strict “do not feed the trolls” policy on this blog. OK – so it’s more of a strong suggestion frequently flouted. It’s very difficult to enforce. Even saying, “Do not feed the trolls,” is feeding them, and there always seems to be someone who caves to their goading, and then the troll is off to the races.

Commenter Dirk Steele has given us the latest example on my blog from Tuesday. He left a completely off-topic comment with the intent of derailing discussion on the actual topic of the blog post, and someone caved (no hard feelings, I sometimes do it myself, it’s hard to resist sometimes). Dirk was apparently frustrated that I was not responding to his comments on a five year old blog post. I rarely respond to comments on posts more than a week old, let alone five years (I trust you understand why I cannot maintain active discussions on over a thousand posts). I also did not respond because Dirk did not address any of the points I made in the post (actually a series of five posts), but was simply regurgitating Thomas Szasz mental illness denial talking points. My responses, in other words, were already in the posts and did not need repeating.

But it has been a while since I have addressed the issue of mental illness denial head on. I also receive frequent requests to discuss this topic, and ADHD (attention deficit and hyperactivity disorder) directly, so this is as good an excuse as any to revisit this topic. I predict my response will not satisfy Dirk, but at least it will keep him out of other threads for awhile. This is Dirk’s most relevant comment, in which he gives us a Gish gallop of standard mental-illness denial talking points:

Szasz would point out the very concept of a ‘mind disease’ or mental ‘health’ or ‘hygiene’ of the mind is not a scientific concept. It is a metaphor. Szasz points out that psychiatry is a political ideology. I agree with the views of Dr. Novella when he discusses homeopathy, chiropractic techniques, or even crystal healing. Psychiatry has made great claims in the past. Without foundation. Neurology is a scientific discipline that deals with and attempts to resolve empirical objective events. Psychiatry is a pseudoscience. 100 years ago Emil Kraepelin identified 3 mental diseases in hospitals that were full of those suffering from neurosyphilis and encephalitis. Today the DSM describes over 350 distinct mental disorders. You show me the science behind this please. There is none. Zilch. I challenge you and Dr. Novella to demonstrate the science that underpins psychiatry.

I will point out that I have already addressed all of these points in my previous posts, which Dirk admits to reading. He is therefore behaving very much like a creationist, he has his points and will not be dissuaded from them, even when they are eviscerated by sound arguments. Dirk also appears to be like a creationist in that he appears to be basing his opinions entirely on secondary hostile sources. He therefore demonstrates as much knowledge about psychiatry and mental illness as your average creationist does about evolution. When he states, “You show me the science behind this please. There is none. Zilch,” that is about as accurate as a creationist saying confidently there are no transitional fossils.

Dirk begins with the “mental illness is just a metaphor” argument. This is a non sequitur. The neuroscientific model of the mind (and psychiatry is part of neuroscience) is that the mind is what the brain does. When we are talking about mental illness we are therefore talking about a brain disorder. What Szasz (and his acolytes, like Dirk) is doing is playing semantic games in order to cause confusion. Using words to obfuscate rather than illuminate is a classic denialist strategy.

I have debated with mental illness deniers many many times, enough that I know what their standard response is to my counterpoints. What they typically say in response to the “mind is the brain” point is another semantic game – arguing that brain diseases are treated by neurologists, not psychiatrists. This is both fallaciously and factually incorrect. This is a version of the “no true Scotsman” logical fallacy – using the definition of categories in order to force a point. The fallacy derives its name from the argument that all Scotsmen are brave, but when confronted with a counter example (a Scotsman that is cowardly) responding by saying, “Well then he is no true Scotsman.” This is a semantic way of dismissing counterexamples by definition, therefore making a circular argument.

Those who wish to maintain their premise that psychiatry is pseudoscience respond to all counterexamples by saying that, well then that disease or disorder is not psychiatric, is neurological. They therefore define psychiatry as encompassing any mental disorder that they do not believe is legitimate, and not including any demonstrably legitimate diagnoses.

Further, it follows an understanding of modern psychiatry that is simply out of step with reality. It is more similar to what psychiatry was like 40 years ago – which is generally true of Thomas Szasz’s positions. He is a psychiatrist who campaigned against the abuses and weaknesses of psychiatry. He had some legitimate points – but all of them have already been conceded over the years. Others have argued that Szasz should just declare victory and move on, instead he has persisted in his anti-psychiatry campaign.

Also, the lines between neurology and psychiatry have blurred over the years as we have learned more and more about brain function and how it relates to illnesses. Psychiatry is now more of a clinical emphasis than a distinct discipline from neurology. Psychiatry still deals with brain disorders, but focuses on those that primarily manifest as disorders of mood, thought, and behavior. These are not fundamentally different from brain disorders that manifest as abnormal movements, pain, language or cognitive problems, but those are treated by neurologists. Psychiatrists have also been steadily moving toward biological treatments of psychiatric disorders, as we learn more about their neurological causes, increasingly leaving therapy to other mental health professions, such as counselors and psychologists.

Throughout his comments Dirk also refers over and over to mental “diseases.” I had already addressed this in my previous posts as well. Many psychiatric diagnoses are not classical diseases in that they do not involve pathology. They are classified as disorders, defined as a deficiency of a function or ability normally possessed by most healthy individuals resulting in demonstrable and specific harm. Let’s take ADHD as an example.

Like many diagnoses in medicine (not just psychiatry) ADHD was first identified as a clinically defined syndrome. Over the years researchers have tried to understand what is different in the brains of those who meet the clinical criteria for ADHD from those who do not. This is complex, because many brain disorders are actually a complex set of related disorders that manifest with similar symptoms. Even non-psychiatric disorders, like migraine and autism, and really categories that have many underlying biological influences. ADHD is no different.

But there are some consistent themes that have emerged. The most prominent theory of ADHD at this time is that it is mostly a deficiency in executive function (EF). EF is a function of the frontal lobes that allows us to focus our attention, to be goal-oriented, and to consider long-term strategies and consequences of our behaviors. Diminished EF explains many of the features of ADHD and the demonstrable harm that those with an ADHD diagnosis suffer. In one 2005 systematic review the authors concluded that there is robust evidence for EF disorder in those with ADHD, but that EF dysfunction is not a universal or required condition for ADHD. Therefore, “Difficulties with EF appear to be one important component of the complex neuropsychology of ADHD.” Other reviews agree, citing evidence for EF dysfunction in ADHD but pointing out that ADHD is a heterogeneous disorder and needs more study to define its subtypes.

If you read this study, and many others like it, you do not find the evasion and vague nonsense of a pseudoscience, but rather the process of legitimate science earnestly exploring a complex disorder, considering alternatives, probing for weaknesses in the data, etc. It does not, in other words, resemble the straw man that mental illness deniers attack.

ADHD is demonstrably a brain disorder and fits well into our current models of brain function, specifically the role of executive function in guiding our attention and behavior. It is also clearly more than that, and so further research is ongoing. The brain is complex and teasing apart the interaction of all of its various parts and systems takes time. It is not fair to dismiss all the science behind ADHD as pseudoscience. That opinion is not evidence-based, it’s outdated denialist propaganda.

There is much to criticize in psychiatry’s past, and it has been a long slow climb out of the infancy of this field when it was more pseudoscience than science. Modern psychiatry still has many challenges before it. Thomas Szasz began with legitimate concerns about the abuses of psychiatry. His complaints, however, are now mostly decades out of date. He has also thrown the baby out with the bathwater – not content to campaign against the deficiencies of psychiatry in practice, he went way too far in concluding that the very concept of mental illness itself is pseudoscience, making Szasz, in my opinion, a crank. His followers, in my experience, are hard core deniers. They are about as engaged in the modern science of psychiatry as creationists are with the modern science of evolution.

472 thoughts on “Responding to a Szaszian”

I always enjoy reading about this topic and learning more about the science behind modern psychiatry. Mental illness affects so many and often goes undiagnosed. The deniers are only making the situation worse with their nonsense.

I see at least 2 classes of deniers: the hardcore deniers like the Szasz followers and then the people that acknowledge the possible existence of mental illness but think the majority of mental illness is actually a medical illness with presenting psychiatric symptoms (i.e. hypothyroidism). See the link below for more on this type of denial. The latter group also loves to claim that we are overmedicating/overdiagnosing mental illness. I freely acknowledge that this is a possibility. Our society loves to find a pill for every problem, but that does not mean there we should not ever medicate or diagnose mental illness.

I know this day will probably never come, but I really hope we do have a blood test or MRI scan someday that can objectively diagnose mental illness. I know that won’t shut up the hardcore deniers, but I hope it will help convince the fence sitters that psychiatry is a science-based medical specialty.

I plead guilty to feeding the troll. I was in the midst of writing up my “grand unified theory of neuropsychiatric disorders”, but got sidetracked into writing up my “grand unified theory of physiology”, of which it is a subset, so it was difficult for me to resist. 😉

But seriously, most people have a difficult time thinking logically while doing anything, including science. They default into the ways of thinking that Feynman called “cargo cult science”. Motivated reasoning to try and fit observations into a schema that they understand.

The brain is complex enough that on some levels there is insufficient commonality to do “statistics”, that is every example of a human brain is a unique piece of data so one really does have a collection of anecdotes and not necessarily “data”. That doesn’t mean scientific study is not possible, it just means it is more difficult and less certain. It also means that the results that humans generated using anecdotes, folk medicine, folk psychology, folk physics are more difficult to distinguish from results based on scientific study.

What I have recently been thinking about is how human hyperactive agency detection makes it difficult for humans to look at things like physiology and not “see” top-down agency. In the past this top-down agency was attributed to God, to “spirits”, to “the mind” or “the will”, and now it is mostly attributed to “genes”, even as the ever larger GWAS don’t show evidence of such a thing. There is no top-down control of anything in physiology or neurophysiology. That will be a very difficult thing for some people to accept.

Even though I share some of their conclusions that some specific ideas about psychiatry are not correct, I do not share the denialist mindset that Szasz followers have. I have specific logical reasons why specific ideas are or are not correct. The analogy with creationists is apt. They have no arguments for a unified model that fits the data better than current models, they just want the current model to be rejected.

To understand something as “science”, you need to be able to cognitively manipulate data using logic to make conclusions and predictions. There is no such thing as “intuitive science”. If you have good intuition about science, then your intuition can be a starting point, but it isn’t “science” until it can be reduced to facts manipulated logically.

Speaking as a parent with a child who was diagnosed a couple of years ago with a life-threatening mental/brain disorder (anorexia nervosa), which turned me into a lay consumer of relevant research, I find this Szaszian business to be patently absurd.

Sure, not all of the research in this dept. is equally compelling (and, sad to say, it appears that most therapists who advertise treatments for eating disorders are working with out-dated, evidence-challenged models), but that judgment comes from acquiring critical thinking skills that these Szaszians must willfully lack in order to preserve their tribal identity.

I would ask these questions to any denier of psychiatry/psychology as a science as a basis for having a debate:

1. You have a population that is in some kind of distress. There is some problem (behavioral usually) affecting the quality of their personal and/or professional life. Do you acknowledge that this constitutes a need for some intervention?

2. Do you acknowledge that the brain is something we have an incomplete understanding of? We do not yet completely understand the interplay been been neuroanatomy, neurochemistry (neurotransmitters and signaling, etc.), environment and brain functions like memory, mood and personality. So I am really just asking do you acknowledge that we do not have a precise, mechanic’s insight into what leads to what in the brain?

3. Do you acknowledge that alternations to the brain (its anatomy and its signaling) can have effects on its functions (like memory, mood and personality)?

4. Given that we cannot completely trace a behavioral problems (as in #1) to its precise physical and chemical cause because we do not yet have that complete level of understanding (as in #2)…What would you have scientists interested in the problem do? Do you feel these problems cannot be studied scientifically?

What I’m getting at:

Are you in favor of completely ignoring behavioral problems (#1) causing people distress? Basic scientists are studying the brain from every angle we know how (physiology, molecular biology, biochemistry, etc.), so that’s covered. But what we see, clinically, are populations that have difficult to pin down spectrums of problems (“disorders”) that people are trying very hard to categorize so we can be consistent and apply a field of knowledge to. It’s incomplete; it’s a mess; everyone acknowledges that. But there is a stage of science where things aren’t crystal clear. It doesn’t mean you can’t study it scientifically. It means it needs to be studied MORE until we arrive at a complete, satisfactory picture. Until then, we have to do the best we can to alleviate distress.

Last point: the first thing a scientist learns is that science is messy. It takes decades of building upon foundations to learn anything. No simple answers for complex conditions.

Dirk – it was not ridicule, it was an apt comparison. Your argument style is that of a denialist. Deal with it.

I acknowledged in my post that ADHD is heterogeneous. This does not mean it does not exist as a clinical entity. Arguing that because it is complex that the core claim is not real is not a valid argument and is a classic denialist strategy. It is doubt-mongering – pointing to current uncertainty or exceptions, which will always exist, even in rock solid sciences.

You then go on to cherry pick a study and imply is casts doubt on the reality of ADHD. First, even if ADHD were overdiagnosed that would not mean it’s not a real diagnosis (so that’s a non sequitur). The very concept of overdiagnosis only applies if the diagnosis is real, so the point does not even make sense.

Further, what the study you linked to indicates is that teachers may not be accounting for relative age when considering which children should be screened for ADHD. There was a difference when considering children 11 months apart in age but in the same grade, something the teachers were probably not adjusting for. Also this is a single study and does not allow a conclusion of cause and effect.

Thanks for this review. I harbored strong suspicions that psychiatry was a pseudoscience. (I mean, Jung was just bugnutty crazy.) After reading this my opinion is now “It used to be, but not anymore.” I appreciate your bundling up the arguments here.

@SARA my guess is dirk will respond that any number greater than 0 is over diagnosis, but his real intent is to blur the line to claim their is none. Any ambiguity or room for doubt allows him to claim the whole thing is false, whatever the rest of the evidence points to. Any little thing he can find in a large body of scientific literature will be construed as a crisis for psychiatry, because its not like physics, therefore pseudoscience.

The fact that I am European may have a bearing on the matter. In the World Health Organisation’s International Classification of Disease, ICD-10, ADHD does not even exist! It is an American invention via the DSM. Even Allen Francis admits this fact.

As Tom Insel states “We don’t talk much about this, but when it comes to mental illnesses, psychiatrists lag far behind their colleagues in other specialties. “Diagnosis is by observation, detection is late, prediction is poor. Etiology is unknown, prevention is undeveloped. Therapy is by trial-and-error. We have no cures, no vaccines. We’re not even working on vaccines. Prevalence has not decreased. Mortality has not decreased.”

In my experience as a patient – and this is anecdotal of course, although it has happened many times – psychiatrists and clinical psychologists engage in numerous forms of dubious practice which border on pseudoscientific. A classic example is the frequent claim that by trying one antidepressant after another, they will eventually find one that works. It is a claim that can be proven but never falsified.

‘I would ask these questions to any denier of psychiatry/psychology as a science as a basis for having a debate:’

Thanks for taking the time.

1. You have a population that is in some kind of distress. There is some problem (behavioral usually) affecting the quality of their personal and/or professional life. Do you acknowledge that this constitutes a need for some intervention?

Draptomania anyone?

2. Do you acknowledge that the brain is something we have an incomplete understanding of?

We have little idea how the brain/mind works.

3. Do you acknowledge that alternations to the brain (its anatomy and its signaling) can have effects on its functions (like memory, mood and personality)?

Yes obviously.

4. Given that we cannot completely trace a behavioral problems (as in #1) to its precise physical and chemical cause because we do not yet have that complete level of understanding (as in #2)…What would you have scientists interested in the problem do? Do you feel these problems cannot be studied scientifically?

We must be careful. USSR citizens were diagnosed as schizophrenic for anti-communist views. It is my view that ‘deviance’ from the norm has been defined as a medical issue. I am not sure that this is a credible scientific position. I could be proved wrong. I am just waiting.

What I’m getting at:

Are you in favor of completely ignoring behavioral problems (#1) causing people distress? it’s a mess; everyone acknowledges that. But there is a stage of science where things aren’t crystal clear. It doesn’t mean you can’t study it scientifically. It means it needs to be studied MORE until we arrive at a complete, satisfactory picture. Until then, we have to do the best we can to alleviate distress.

I am a complete supporter of science and scientific methodology. I am not trying to ignore behavioural ‘problems’ or the great distress and suffering that people experience. I just do not accept that this is caused by a mental disease/illness/disorder/spectrum. It is my view that environmental causes should not be discounted.

‘Last point: the first thing a scientist learns is that science is messy. It takes decades of building upon foundations to learn anything. No simple answers for complex conditions.’

Agree. I think that it is current psychiatry that attempts to provide the ‘simple’ explanation. I am not convinced.

Thanks for your contribution to the debate. . The fact that millions of American children are forced to take psycho-active drugs that very many scientists consider to be toxic and which actually cause brain damage, as proved by science, is irrelevent.

We are busy building prisons in the U.S., and we have a justice system which provides sentences for offenders for US laws. If you don’t like psychiatry with its disorders and chemical restraints, then you can send your problem citizens directly to jail. My behavioral science work in the trenches of Midwestern state hospitals was counting assaults and batteries to staff and clients, and then trying to program the offenders to do these less often. How do you program someone who enjoys batteries and killing to do it less? Given this true state of affairs, the only real counselors are lawyers!

Thanks for answering the questions, I know a lot of them were obvious but I’m trying to understand the basis of your perspective.

First, I need you to clarify your position on #1. Drapetomania is not fair if you are meaning the completely racist take on it. Let’s just use depression. You have people that are depressed to the point where they cannot function in social or professional environments. Do you acknowledge this person could benefit from help? If not depression, let’s take the extreme of schizophrenia. In other words, do you believe that psychological problems (whether environmental or not) exist and that people disabled by them should receive help?

I’m assuming your answer to the above is “yes” as I go on…

It is my view that ‘deviance’ from the norm has been defined as a medical issue. I am not sure that this is a credible scientific position … I just do not accept that [behavioral problems/suffering therefrom] is caused by a mental disease/illness/disorder/spectrum. It is my view that environmental causes should not be discounted.”

– Dirk

From reading your answers to my questions, here is what the core of your argument boils down to. Please correct me if I am wrong (but it has to be a direct, concise statement like I am about to give!):

You see psychiatry as trying to correct a problem that does not exist. For what problems do exist, you attribute suffering
to environmental causes that do not manifest through brain changes.

For the first part, I think I will have no trouble getting you to admit that psychiatry does not deal exclusively with “deviance from the norm” and the stigma that is associated with that; it deals with disability. There is a difference between a person that is weird and a person that cannot hold a job because they are depressed. For the most part, “disorders” are by definition situations that decrease the quality of life a person is experiencing to a significantly degree. Psychiatrists don’t diagnose someone that is autistic, for example, simply on the basis of being socially awkward.

I think you are also trying to say that what we define as a disorder is a simple social construct with a sliding scale based on what people find convenient. Your “anti-communists are schizophrenics” thing from the USSR is an example of that. But that is not mainstream psychiatry; that is the same crazy camp in the field as homeopaths are in the field of medicine. Of course every field grows tighter over time, and psychiatry is is still maturing. There are bound to be things affected by the culture of the time, but these are flaws in people not in the science (which is self-correcting over time). We can’t have this discussion by sticking to extreme examples of political ideals or homosexuality being diagnosed as disorders. What do you have to say about a mother that cannot care for her children because of depression? Or the schizophrenic that is completely impaired because he feels persecuted by anyone he may have contact with? These ARE problems and they need help. They are not defined by cultural bias on any real, practical level and can’t be dismissed.

Point 2. It is your view that environmental causes cause distress but that this distress is not a mental disease. Well, I’m not sure I follow you here. First, psychiatry does NOT exclude environmental causes. If a person is in a destructive environment, that is obvious. Often times, though, the environment is not obviously destructive and either way it cannot be changed. A person who is depressed must still live in this world. And for anything to be experienced, environment must translate into some mental input. There is just no getting around that. Some people have altered perspectives that are sufficiently outside their ability to cope.

I see you looking at something like ADHD from your perspective as: “it’s nothing in the brain, it’s just lower than normal intelligence and the environment the person is in is not one where someone like that can succeed like that.”

But this is an uninformed view on the science behind ADHD. It’s overly simplistic and dismissive of problems. And this view cannot be so easily applied to schizophrenics. It also doesn’t explain why pharmacological interventions show benefit or why there is a genetic component to many psychiatric disorders.

Finally

Agree. I think that it is current psychiatry that attempts to provide the ‘simple’ explanation. I am not convinced.

”

We have models, hypotheses and theories. No one is reporting anything to be the definitive answer. Every psychiatrist worth noting understand the complexity involved. But we have to do something. We can’t just not study the problem. It all has to start somewhere. And if you doubt that scientific, rigorous methods are being applied to study where legitimate problems exist, then you have not seen the methodology in the studies (controlled, systematic, statistically approaches to understanding).

Sir Ken Robinson does not seem like a denier, but he is misinformed, and he admits he is not expert. Medication for ADHD is not a sedative. It’s a stimulant – to increase executive function.

I’m all for neurodiversity – but in order to be considered a disorder behavior does not only have to be different it has to be lacking in some definable way and cause demonstrable harm. Demonstrable harm – like a higher divorce, rate of incarceration, lower lifetime earning potential, greater propensity so suffer from accidents, poorer academic achievement, etc. The outcomes correlate with decreased executive function. They improve with treatment.

Dirk continues to attack pathetic straw men, a cite poor sources. First you have to understand psychiatry before you can criticize it. You are raising some points that have been brought up by psychiatrists decades ago and have been addressed in the research.

Dirk then takes quotes out of context as if they cast doubt on the existence of mental illness – classic denialism.

Regarding cherry picking – citing systematic reviews is by definition not cherry picking. I cited the two most recent (and therefore most up to date) systematic reviews. That’s a way of looking at all the evidence – the very opposite of cherry picking. You cited and misrepresented one study.

An around we go – this is the denialist dance. Thanks for demonstrating.

It means it needs to be studied MORE until we arrive at a complete, satisfactory picture. Until then, we have to do the best we can to alleviate distress.

But isn’t this exactly what is going on right now in these fields? Steve laid out some compelling evidence that ADHD can be related to abnormalities in executive function. We have a decent amount of knowledge of executive function processing, such that experiments could come about from this understanding. So, more work is being done so that we can arrive at a complete, satisfactory, picture.

What I’m saying is that the work is being done now to validate these observations. However, that doesn’t give someone free reign to go around suggesting the whole practice of psychiatry is bogus just because the answer isn’t there yet.

Thanks for that post. It at least opens the debate with what I consider pertinent questions. Is depression the result of a mental disorder/biochemical imbalance or caused by environmental or societal pressure? Do children suffer from the brain disorder called ADHD or is this the result of changes to our educational environment in which certain children cannot cope? See the vid by Sir Ken Robinson. I am skeptical of the current psychiatric science which claims to know. I play the devil’s advocate in order to force people to challenge the current orthodoxy which I consider to be causing more harm than good. (I read Anatomy of an Epidemic by Robert Whitaker.) The alleviation of suffering is the ultimate goal. We may feel we have to do something but sometimes the wrong action is worse than doing nothing. I would like to reply in detail but my approaching bedtime and white wine inebriation suggests it is time to keep my mouth shut.. 😉 (for once…)

For example, I recognize that not all educational settings are appropriate for my children (again, one of whom was diagnosed with anorexia nervosa, and the other with Asperger syndrome), and sometimes the system (or at least its local branch) is partially to blame for the mismatch (e.g. if/when it provides inadequate understanding of and support for disabled children).

Yet having a diagnosis can be a tool for parents to advocate for social change (e.g. via appeal to Section 504 of the Rehabilitation Act and the Americans with Disabilities Act here in the US), as it helps to communicate how/why one’s child’s behavior does not fit the norm.

Of course, with or without a diagnosis, we all need to make an effort to adapt to whatever environment(s) we find ourselves in, if we wish to survive and flourish.

Why is it so difficult to understand that the realm of science is manifold and inclusive of fields that organiclly build toward a better whole.Science is a partnership of evolving modes,methods and diagnostic tools.These continually provide interdisiplinary feedback that fashions a broader and sharper new model.And most importantly the new model has shed the previous biases and “resonable doubt” that has bullied it.Evolution is not only a process of physical change but,also, a process of cognitive change,piecemeal.

As for the aspect of ADHD.

It starts as intuition that there is some dimension of the ADHD condition that is removed a distance from the “typical” brain.At the beginning,only case study could
point to a diagnosis.Psychiatry,however you want to view it provided the tender means of creating an association between a life in chaos and a biological cause.It’s a slow “evolving” process and partnership with neuroscience that will refine itself over time.

Dirk I didn’t say you didn’t look for scientific papers I said you were looking for anything that would seem to back up your point and ignoring things that didn’t. For example you cited an education expert with a liberal arts background, and a 1977 paper in a social science journal that criticizes another paper from 1975. The other thing you cited was from a press release as opposed to an actual article. You can find the full text article online here. Even though its a large study it doesn’t control for the potential for older children to by under diagnosed a limitation the studies authors admit to. That issue is addressed in the review Steve, where the abstract states the researchers sought to compare false positives to false negatives.

Of course the strengths and weakness of each study don’t matter if the point is not to find the truth.

Do children suffer from the brain disorder called ADHD or is this the result of changes to our educational environment in which certain children cannot cope?

Just Asking Questions, which have already been answered.

I am skeptical of the current psychiatric science which claims to know. I play the devil’s advocate in order to force people to challenge the current orthodoxy which I consider to be causing more harm than good.

So just disregard the strengths and weaknesses of the evidence of harm, or the methods science uses to make it’s claims, that’s the orthodox way.

Dirk,you are a strident fool,lacking a feeling for the latitude of language.All science. all scientific theory starts with “intuition”.Nothing can be tested or proven untill it can be conjured by the imagination.Everything starts with a drift of thought,a daydream,an “intuition about something we can not see,but feels true.

I have addressed the concept of “typical” or “healthy” at length on this blog – beyond mere quotation marks. Dirk is mostly playing with semantics. It doesn’t matter what you call it. Some people have less ability in certain specific and measurable ways than most other people. These decreased functions correlate with negative outcomes that most people find undesirable. With ADHD, part of that lack of ability is the ability to adapt and thrive to the typical school environment. We can change the school environment, and to some extent we do, but that doesn’t seem to adequately address the problem Further, once you get out of the nurturing school environment you are likely to find that the world is not going to adapt to you.

All of these issues are addressed in a very thoughtful way in the literature, but you would have no way of knowing that if you rely upon only clueless hostile sources with an agenda.

People here don’t usually agree on a lot. We love to challenge points, that Steve and the other commenter make. We agree, that you are dead wrong. If you cannot accept, that this is likely due to you being in fact wrong, then at least accept that you won’t convince anyone here of the opposite, and save your energy for someone more gullible.
And don’t complain about Steve’s language, its his blog and if he wants to be a little rough on you, that’s his right.

From Dirk’s responses I’m inclined at the minute to think that he is not a die hardened denialist more that he has fallen for denialist arguments. I can understand Steve’s exasperation but I think it’s worth remembering that the reason denialism proves so successful is because it offers cognitively appealing explanations. I know that doesn’t make the ‘denialist’ merry-go-round any more fun to deal with but I think it does justify giving Dirk a fair shake and seeing if he can change his views in the light of being presented with compelling evidence to the contrary of his position. Though maybe I am getting too optimistic… anyhow, giving Dirk the benefit of the doubt, I have a couple of arguments/comments to put to him.

1. Steve answered your challenge about cherry picking- he is citing recent systematic reviews and you cited single specifically selected studies to support your conclusions. Can you acknowledge that you may be guilty of cherry picking or are you claiming that you have surveyed the relevant research literature? If so why do you think your single study is more significant the recent reviews which obviously consider the existing literature in much greater depth?

2. Ken Robinson is an education specialist but he admits in the video that mental disorders are not his area nor he is familiar with the research literature- he mentions that those who are agree that there is strong evidence that ADHD exists and that it is a complex phenomena. As such why should I find his uncertainty about ADHD more compelling than the general consensus of the relevant researchers he mentions? Ben Stein is a well regarded figure in entertainment and generally seemed to have a reputation for being an intelligent man- he believes Evolution is a flawed theory and that there is a conspiracy to suppress the legitimate science of Intelligent Design, following the logic you are offering for accepting Ken Robinson’s perspective it seems like I should also be swayed by Ben Stein. What is the difference?

3. If you are interested in the relative significance of environmental vs. genetic influence on ADHD I wonder if you have done any research into the relevant literature. Are you aware if there have been twin/adoption studies to try and disentangle environmental/genetic contributions? If not why not? Playing devil’s advocate is one thing but conducting some sincere research in the relevant research literature not simply reading anti-psychiatry sources would seem necessary to have a properly informed opinion on the topic. Are you actually reading studies which are not linked to on anti-psychiatry sources?

1. Steve answered your challenge about cherry picking- he is citing recent systematic reviews and you cited single specifically selected studies to support your conclusions. Can you acknowledge that you may be guilty of cherry picking or are you claiming that you have surveyed the relevant research literature? If so why do you think your single study is more significant the recent reviews which obviously consider the existing literature in much greater depth?

I am guilty of cherry picking. It is not ‘my’ single study… I can give many more examples. It is that Steven accuses me when he is just as guilty.

With a “psychiaric” condition such as ADHD you can only come at it in a rounded exploration of self impression and life situation(cause and effect).If the noble goal is to allieviate someone towards the stigma they feel about themselves,then its pointless to be indignant as to how that process starts.If not in the psychiatrits office then where ,do you begin to coomb through the the problems of a life lived with ADHD.It’s as if you want to remove the compassion between psychiatrist and patient that is lending neurologic evidence to people who feel ragged and confounded

Dirk, insults are not arguments and neither is the arguer the best judge of whether he has properly made his points. Is anomalous thinking insignificantly an effect of disease, or is disease a significant cause of anomalous thinking? If your anomalous thinking has not been all that successful, you might wonder if there’s more than one reason why. Who would you likely pay to find that out? Not even a psychologist?

“Do I get the sympathy vote then?”
– You get the benefit of the doubt vote though it’s quickly evaporating. Whether you remain convinced by denialist style arguments or look deeper into the research literature the cognitive appeal of denialist arguments will remain live and well however.

“I am guilty of cherry picking. It is not ‘my’ single study… I can give many more examples. It is that Steven accuses me when he is just as guilty.”
– But he isn’t and you didn’t acknowledge his response. Steve is citing recent systematic reviews- you are citing articles selected from anti-psychiatry sources. This is the same tactic as a creationist who continues to cite ‘lots of studies’ to support their argument that evolution is a flimsy theory. Citing individual studies and ignoring the wider research literature/systematic reviews is not a sensible way to conduct research. It is however a good way to confirm a pre-existing bias.

‘Dirk, insults are not arguments and neither is the arguer the best judge of whether he has properly made his points. Is anomalous thinking insignificantly an effect of disease, or is disease a significant cause of anomalous thinking? If your anomalous thinking has not been all that successful, you might wonder if there’s more than one reason why. Who would you likely pay to find that out? Not even a psychologist?’

Pretty much agree here. Tho are you accusing me of making insults? Where?

Dirk to me: But obviously they must have suffered from a brain malfunction (aka Dr Steven Novella).

Not obviously. That’s what the research shows. But I’ll leave the study citations to others.

Suffice it to say that, insofar as this conversation is driven by what’s emotionally palatable, then I find strictly environmental (or “blank slate”) explanations to be at least as disturbing as strictly biological (or “it’s all in the genes”) explanations – particularly when and where it might lead experts and officials in education and social work to lay all of the blame on the parents for failing to raise children who are capable of fitting in, without doing harm to themselves and/or others.

It is not the aspect of an incurable brain disorder that creates the stigma.It is the feeling of disconnectedness,the mystery of why every thing from the mundane to the grandiose never gets off the ground.It’s what someone feels when their distraction is taken as willful and wonton disobedience.What happens after diagnosis is that you feel at least and at last that you are on a continuum with humanity.You even begin a revision of your past where you understand that a divergent brain lacking in certain optimal functioning(executive function) is not the same as being an abject idiot.

“Ok. Show me where I have done this.”
– You are citing single studies and parroting standard anti-psychiatry arguments (i.e. Soviet Union’s use of mental illness). If you found these studies through rigorous research I apologise although I wonder why you don’t seem interested in the findings of recent systematic reviews.

I’ll leave you to it though unless you fancy addressing the points I’ve already made.

“Psychiatrists have also been steadily moving toward biological treatments of psychiatric disorders, as we learn more about their neurological causes, increasingly leaving therapy to other mental health professions, such as counselors and psychologists.”

How well do those disciplines adhere to a scientific approach? As psychiatry has left therapy to those other mental health professions, have they retained the unscientific approaches you said psychiatry was guilty of in decades past?

Individuals were not incarcerated because they had a diagnosis of ADHD, they were incarcerated because they were convicted of crimes, the ADHD diagnosis came later. There is also a pretty strong correlation with crime rate and lead exposure (lagged 22 years).

– You are citing single studies and parroting standard anti-psychiatry arguments

Whereas Dr Novella cites only the truth. According to whatever supports his view.

Are you really trying to tell me that one in ten of American children suffer from an incurable brain disease? That this is a scientific fact? Are you really trying to persuade me that there is scientific proof?

Are you really trying to say that one in ten children have a biological abnormality in their brain?

Really? Or do you at least question Dr. Novella’s stance without scientific evidence? One in ten children have a brain disease?? Are you serious?

Psychology and other “soft sciences” have become much more scientific in their approach and methods throughout the 20th century. Psychology used to be one of Karl Popper’s prime examples of pseudoscience because of the unfalsifiability of Freudian psychoanalysis. However in the intervening decades psychology began to focus on controlled experiments to test hypotheses and have built up a large body of research.

Are you really trying to tell me that one in ten of American children suffer from an incurable brain disease? That this is a scientific fact? Are you really trying to persuade me that there is scientific proof?

‘ Individuals were not incarcerated because they had a diagnosis of ADHD, they were incarcerated because they were convicted of crimes’

Yes and the majority of those icarcerated are convicted via drug related ‘crimes’. The taking of amphetamine type compounds is actually illegal. Those who are forced to be addicts remain addicts. If marijuana was legal then the prison population could be halved with a single stroke. But you perpetuate this bizarre unscientific view that these people suffer from an abnormal brain disorder. This is a crazy view. It is the attempt by ‘society’ to control devience by medicalising it.

Are you really trying to tell me that one in ten of American children suffer from an incurable brain disease? That this is a scientific fact? Are you really trying to persuade me that there is scientific proof?

Yes Dirk, yes we are.

Oh i thought it was one in five. Or maybe every single child suffers from a brain disorder. Ok I am wrong to dispute this fact.

You could try clicking on the link, just for a fun, it’s an article that lays out a long list of neuroimaging studies showing differences between the brains of children with ADHD compared to the general population. The article put the number of children at much lower than 1 in 10 fyi.

You asked about brains, I gave a link about brains, the least you could do is take a look. It’s the hard science you’ve been asking for.

If you are less competitive and/or less cooperative than your fellows, and a psychiatrist could consistently do something that would change you for the better, would you really care if the problem had the label of disease and not disorder? Or do you want a problem simply called a problem and skip the labels altogether?
Your argument seems to be that a psychiatrist is worthless regardless of the labels or the symptoms, and your argument is sound because you keep saying that it is. And sounder when those who disagree talk “rubbish.” Is talking rubbish recognizable as a disorder?

“I am not trying to ignore behavioural ‘problems’ or the great distress and suffering that people experience. I just do not accept that this is caused by a mental disease/illness/disorder/spectrum. It is my view that environmental causes should not be discounted.”

What evidence would convince you that there are mental disorders that need treatment? Do you really think that it is all environmental and that the brain is impervious from any type of problem other than trauma? Tell us what type of evidence is lacking that would allow you to change your mind about mental illness?

“A sure sign of a pseudoscience is lack of progress”
-Really? So a person diagnosed with schizophrenia will fair equally well in a psych center in 1932 as he/she would in 2012? You better reevaluate your perspective of no progress. Its true that psychiatry has a sordid past, but this is reflective of societal attitudes over that time. This field appears more problematic, because it involves the treatment of a vulnerable population, of which societal attitudes have changed a great deal over the time in which the field was maturing.

The point is that progress has been made, and a great deal of progress, which makes your assertion of no progress all that more absurd.

ADHD is not a disease, it’s a disorder, as in, “My life is in disorder because of how my brain is wired.”

As someone who has struggled with, but was in denial of ADHD most of my life, I can attest to this statement by Dr. Novella:

“We can change the school environment, and to some extent we do, but that doesn’t seem to adequately address the problem Further, once you get out of the nurturing school environment you are likely to find that the world is not going to adapt to you.”

Maybe I can paint a picture of what the world looks like from the view of someone with ADHD.

Growing up and going to school at a time when there was practically zero awareness of ADHD, my more caring teachers observed I was intelligent and had massive potential, but were frustrated by my inability to focus. I had no concept of “there are certain times for certain activities.” Why people would operate in such a way made no sense to me. I couldn’t comprehend why everyone didn’t just do what they felt like doing at any given moment, or how they managed to resist doing so. When all the other kids were coloring within the lines for 45 minutes straight, I enjoyed it immensely for about 5 or 10, but then proceeded to go play with Legos, then disrupt others with spontaneous conversations, flip my sheet over and draw a dragon, write the names of the Thundercats on the chalkboard, etc.

If I was forced to linger on an activity any longer than that, I’d get so restless I felt like I was in prison, my mind screaming at me to do something novel, bombarding my thoughts with past stimulus (games, songs, imagery) to the point that I could no longer concentrate or decide on anything at all.

People around me who could manage to focus on one activity for longer than 10 minutes appeared to me to be robots – soulless automatons who were missing out on the wider range of stimulus life has on offer. I thought I lived in a world of dull slaves. I assumed everyone else had the same appetite for stimulus as me, but were just easily broken and defeated, submitting to authority.

Questions like “What do you want to be when you grow up?” didn’t make sense. I want to try everything, of course, don’t you? I will be an actor, then an artist, then a musician, then an astronomer, then President of the World, why not? Why would anyone want to do one thing? That sounds like a nightmare. No one tells you that mastery and specialization are crucial to stay competitive.

“How long will that take?” or “Where do you see yourself in 5 years?” also nonsense. I have no idea because I can’t predict what will engage my attention from one moment to the next. I couldn’t estimate time blocks because I had never been able to execute a lengthy task from start to completion in one solid block of time. Calendars, notes, organizational tools of any kind are all white noise. Redundant to the actual thing you’re trying to organize.

Quick tasks that should seem effortless like filling out a form or doing the dishes are almost impossible to focus on. This is counter-intuitive to most people as they are so simple and short, but the incredible banality of these activities is like kryptonite to an ADHD mind.

It was obvious I got bored easily, but there’s only so much a school can do to try to engage students like me without sacrificing time and resources from others. Maybe someday the education system will join forces with the video game industry to find ways to adequately engage us. I think that is just beginning to be explored.

The first time I tried stimulant medication was the first time I was able to see from the perspective of “normal” people, and understand that they are not in fact robots. The quietness of mind and ease with which I could consider a goal, formulate a plan, and assign attention towards it, was a revelation. I felt like, for the first time, my potential could be unleashed. I’ve always been bombarded with fleeting ideas with the pressure of a fire hose, but cursed with a microscopic nozzle that sputters and spurts aimlessly. Now I felt like I could choose one stream and bust the valve wide open.

I’ve been fired a lot, told by teachers and bosses I was slow, incompetent or had a poor work ethic. None of which are true. It’s just that my productivity is constantly interrupted by the noise in my head and desperate impulses to find high stimulation.

I don’t view myself as a broken unit. I know what my strengths and weaknesses are and the creative value I have to offer. ADHD-ers might not produce large bodies of work, but may be hyper-observant and constantly cross-pollinating ideas from a broad spectrum of disciplines. . I’m just unlucky enough to be born into a structure whose expectations I can’t meet without a little prosthetic pick-me-up for my handicapped executive lobe. Unfortunately, it’s a handicap that is invisible and seen as a character flaw by most employers. No one listens to your ideas unless you have that credential of a large body of work.

Framing the phenomenon as “here are some special people that need special attention, not medication” is great for their self esteem, but doesn’t help manage symptoms while we wait for someone to develop an MMORPG about algebra or paying your taxes.

I’m so thankful to people like Dr. Novella for raising awareness in this regard.

“Suffice it to say that, insofar as this conversation is driven by what’s emotionally palatable, then I find strictly environmental (or “blank slate”) explanations to be at least as disturbing as strictly biological (or “it’s all in the genes”) explanations”

Mufi, it is interesting that the environmental comment was one of the few times that Dirk has offered anything to the conversation beyond doubt mongering and loaded questions, and it failed to elighten. The problem is that although he wants people to believe that psychiatry is pseudoscience, he does not say what would be a more scientific approach, and how that would differ in the treatment of the same group of people (or for whomever among that group who needs help). Pointing out a problem in a field is not the same of demonstrating that it is pseudoscience.

The reality is he has no answers, only questions, and all of his questions are questions of doubt about psychiatry. He demands a standard that is not realistic given the nature of the field (any field focused on humans will be a bit messy due to the complexity of the topic), and he is impervious to any evidence. This is why the creationist analogy is apt. They would demand to see a video of the history of life before they will begin to acknowledge evolution, but even then I think the bar would be raised

Dirk, buddy, everything you want answered has been answered in this post and thread by many willing participants yet you still choose to fall back on arguments like:

Are you really trying to say that one in ten children have a biological abnormality in their brain?

You say that three times man! In one post! It is like a creationist standing up and saying in exasperation over and over something to the effect of, “And humans evolved from apes? Really? You expect me to believe that humans evolved from apes?” So please, save the hurt feelings for a time when you might really need them.

Also, in regards to this whole cherry picking thing you said:

Whereas Dr Novella cites only the truth. According to whatever supports his view.

He’s cited the two most recent reviews. These aren’t just his opinions, they are stacks of verifiable facts. Reviews are usually written to bring together all of the current knowledge on a subject matter. When weighing the one paper you cited against those two articles, is it any wonder why your arguments are met with scoffs and jeering? You keep saying there are tons of other articles out there that support your argument, but you’re unwilling to do anything outside of what amounts to a self-only-circle-jerk of one logical fallacy after another. I mean, if you want to be taken seriously, bring something to the table that hasn’t already been discredited.

‘You could try clicking on the link, just for a fun, it’s an article that lays out a long list of neuroimaging studies showing differences between the brains of children with ADHD compared to the general population. The article put the number of children at much lower than 1 in 10 fyi.’

I am attempting to find and read the original papers from the 1990s. There is currently no accepted biological marker for ADHD. Obviously these studies, which are actually contradictory, have not been replicated and are not accepted by the APA, NIMH etc. Why? The paper you quote from was written in 2004 and the prevalance of ADHD has increased markedly since then.

The study which I have cited and which you dismiss involved 900,000 children.

‘What evidence would convince you that there are mental disorders that need treatment? Do you really think that it is all environmental and that the brain is impervious from any type of problem other than trauma? Tell us what type of evidence is lacking that would allow you to change your mind about mental illness?’

I am looking for objective measurable scientific evidence. Neurology, for example, has made great progress in dealing with brain pathology/disease/trauma.

I can cite studies from the WHO that show that the outcomes of modern psychiatric treatment of schizophrenia are far worse in the US than in the developing countries such as India or Nigeria. It is not that progress is being made but the opposite. The situation is far worse today.

As for ADHD there is no evidence at all that outcomes are improved in academic performance. To quote Russell Barkley ‘the major effects of methylphenidate appears to be an improvement in classroom manageability’ The teachers and administrators benefit. The child does not.

He cited papers from 2005, and 2006. I provided a link to a paper from March 2012. A study which involved 900,000 children.

‘You keep saying there are tons of other articles out there that support your argument, but you’re unwilling to do anything outside of what amounts to a self-only-circle-jerk of one logical fallacy after another.’

Not only am I a ‘hard core’ ‘Szaszian’ but I also have read the works of Richard P Bentall, Robert Whitaker, Peter Breggin, Dr Joanna Moncrieff etc. I also follow such web sites such as Mindfreedom, Psychrights, Critical Psychiatry Network and read blogs such as http://1boringoldman.com/, and http://neuroskeptic.blogspot.co.uk/. I am familiar with the current controversies surrounding the DSM5. Where are you coming from?

Dirk, I would be very interested in a link to the studies of relative effectiveness of psychiatry in the US and in Nigeria. I am working with commensal, topical ammonia oxidizing bacteria which modern bathing removes. The loss of that NO does exacerbate all conditions associated with stress. Living in the “wild”, in the bush in Nigeria could be protective (to a degree).

To a first order, medical practice is the same everywhere. MDs in Nigeria read the same literature, read the same textbooks that MDs in the US read and have access to the same drugs. Cultural practices may be different, but that relates more to how non-professionals relate to those with mental disorders, put them in prison (US), burn them as witches (Europe 1600), treat them with best practices medical care (which changes as more is learned).

Psychiatry is very likely to be practiced much the same in Nigeria as in the US because all it takes is training and not the fancy equipment that costs so much.

@daedalus2u
Dirk Steele is probably refering to the better prognosis of mental illness, especially schizophrenia in Africa.
This is believed to be due to a wider acceptance in the general populace.
This paper offers an overview and a critique of the issue:http://www.ncbi.nlm.nih.gov/pubmed/19894340

I am coming into this late, but I grew up with a mother who was eventually diagnosed and treated with bipolar disorder with some form of psychotic features (she never really gives details, but I think it is something like schizoaffective disorder)… When I was a kid growing upthere would be times where she would get off balance mentally and would be by even my crude child mind at the age of say 10 years old…and when my older brother and I were diging a large hole next to an apple tree in my grandmothers yard looking for the human remains of all the evidence of a massive conspiracy – this all preceeding the eventual total screaming, yelling, and total break from reality and a psych admission….prior to her diagnosis it was a MAJOR problem..led to divorce, and once it was treated I spent alot of time with my mom stable without these major breakdowns..and mostly now-adays she does pretty good…probably once every few years she has some set backs and gets off with her “mental balance” and meds are adjusted. Therapy has also helped her to some degree, but she is unwilling to let dilusions go to some extent it would seem.

Now, I realize that this is only an anecdote, but…umm….I have a hard time understanding Dirk’s logic that would include my mother’s “condition” as just a deviation from the norm or that it is not a “disease”…..

Dirk, with all due respect, so far my reading of your logic, reason, and evidence to back your views does not seem very sound and compelling personally…..my 2 cents for whatever that is worth…maybe not much…

‘The analogy with creationists is apt. They have no arguments for a unified model that fits the data better than current models, they just want the current model to be rejected.’

This is not true. Psychiatrists such as Szasz do have another model that fits the data better than is portrayed within medical biological psychiatry. In particular, Richard P. Bentall’s book ‘Doctoring the Mind’ is very informative.

Sorry, I had read more through the posts…it seems you would say that my mother may be suffering due to some environmental cause, not a “psychiatric disease”….psychiatry and psychologists have helped her stabilize and feel like a normal person more so, rather than an intermittantly raving lunatic…if there was another route for treatment and alleviation of her issues, then I am all ears….and if so, if this alternative treatment has research to show me that it would be effective…thank you.

One study does not undo the consensus of prior research. That study from 2012 does not even directly address the issue of over vs under diagnosis. All you have demonstrated is your inability to read and understand the literature.

Your list of sources that you rely upon also just confirms my suspicions that you are relying on secondary hostile sources – you might as well list a bunch of creationist books and websites and state that therefore you understand the evolution controversy.

You further have failed to demonstrate that you understand the point that ADHD is a heterogenous disorder. In that way it is like autism or migraines. Every objection you are raising to ADHD is also true of these disorder. There is no biological marker used for diagnosis, although research does find differences in brain function. The incidence of migraine in north american women is about 16% – that’s pretty high for a brain disorder, huh? Rates are also much lower in Europe and Africa. Do you doubt the reality of migraines? If not, then you are inconsistently applying your criteria – arbitrary criteria meant to cast doubt on mental illness, and not based on an actual understanding of modern neuroscience.

You also continue to incorrectly use the term “disease” to refer to disorders – this is a propaganda tactic, using what you think is loaded language.

Finally, Szasz and his ilk do not have a model that accounts for the evidence for various mental disorders. Dismissing the evidence and calling it all part of the normal variation does not account for the evidence. It is a hopelessly outdated and superficial understanding of the current state of the evidence. It’s also largely a game of semantics, rather than a genuine attempt to understand these entities.

As someone who is fairly new to these blogs this has been fascinating!
I was going to jump in with some points to refute Dirk’s latest but Steve’s beaten me to it.
One thing I will add is the repeated point that there is no scientific basis is just wrong. I’m currently studying psychology as part of a nursing degree. It includes reviewing different types of psychotherapy and the one thing our teacher repeats is that we must cite research otherwise there’s no science and it’s all just assumption.
There is no shortage of research, my hours of reading back this up.

“Isn’t this all a giant fallacy of the beard?
Dirk et al. of his ilk are saying that because one cannot always determine exactly where eccentricity ends and pathology begins, the distinction between them is invalid.”

I was going to mention the continuum fallacy myself… I did not realize it was also called the fallacy of the beard. Dirk actually uses the extreme version of the fallacy, because he doesn’t just say that the category of a mental disorder is not truly distinct due to normal human variation in traits, but he says mental disorders don’t exist at all because there is variation.

‘That study from 2012 does not even directly address the issue of over vs under diagnosis.’

I was not even attempting to address over vs under diagnosis. The study shows that a child is much more likely to be diagnosed with the disorder of ADHD just by being one of the youngest in the class. The implications of this research undermine your medical biological approach. What is your take on this?

‘Your list of sources that you rely upon also just confirms my suspicions that you are relying on secondary hostile sources – you might as well list a bunch of creationist books and websites and state that therefore you understand the evolution controversy. ‘

I do not understand your logic here. A creationist might tell me that my disbelief in ID is the result of my reading Darwin, Dawkins, W. Hamilton, E.O Wilson, etc etc, which are obviously secondary hostile sources instead of reading the book of Genesis.

‘You also continue to incorrectly use the term “disease” to refer to disorders – this is a propaganda tactic, using what you think is loaded language. ‘

The APA website defines schizophrenia as a brain disease, a severe mental illness, as well as a disorder. Is this a propaganda tactic also?

‘Finally, Szasz and his ilk do not have a model that accounts for the evidence for various mental disorders. Dismissing the evidence and calling it all part of the normal variation does not account for the evidence. It is a hopelessly outdated and superficial understanding of the current state of the evidence. It’s also largely a game of semantics, rather than a genuine attempt to understand these entities.’

Have you actually read any Szasz? Which book was that? How about more modern thinkers such as Richard Bentall?

“…but he says mental disorders don’t exist at all because there is variation.”

Right. It’s like saying diabetes isn’t a pathology because there’s variation in insulin responses (or production – I don’t know shit about diabetes but you get my point) and people with diabetes are just at one end of the continuum.

He’s just adding the continuum fallacy with semantics (what’s pathological? who’s to say what normal is? BS, BS, BS..) to get to some pre-ordained destination. Ridiculous.

I was not even attempting to address over vs under diagnosis. The study shows that a child is much more likely to be diagnosed with the disorder of ADHD just by being one of the youngest in the class. The implications of this research undermine your medical biological approach. What is your take on this?

How does this study undermine the biological aproach to ADHD? It does not deal with the biological approach to ADHD at all. It deals with overdiagnosis. While this is a serious issue, it has nothing to do with pathogenesis or pathophysiology.
And consider this graph from the paper:http://www.cmaj.ca/content/184/7/755/F1.expansion.html
The risk of diagnosis and treatment for ADHD among children born in December versus those born in January is roughly 4% and 3% respectively.

Dirk, I read what is available online of Bentall’s book and I think I understand where the anti-psychiatry people are coming from.

An important factor in social interactions is communication and communication of affect. This occurs mostly via body language, but also through speech. What all communication absolutely requires is consilient coding and decoding neuroanatomy to change the data stream of language into mental concepts and back. When there is a lack of consilience in what I call the “theory of mind” that is used to emulate the thinking of another and so tailor communication such that they will understand it, there is a triggering of discomfort, unease and in the limit, xenophobia (my hypothesis).

I come at this through autism, which is characterized by a non-neurotypical “theory of mind”, and which I think explains why people with autism are bullied much more than people with conditions such as Downs Syndrome with similar levels of intellectual impairment.

I think that a non-consilient “theory of mind” is the reason behind the stigma of mental disorders. Psychiatrists are humans too, so they can experience the xenophobia of a non-consilient “theory of mind” too. Feeling xenophobia toward your patients is unfortunate and would interfere with the therapeutic relationship which is extremely important (absolutely necessary) in psychotherapy being effective. If a patient is able to sense that a psychiatrist feels xenophobia toward them, that would effectively prevent a therapeutic relationship from occurring and would trigger anti-psychiatry feelings. How a psychiatrist or mental health practitioner feels toward their patients is not data about how scientific the field of psychiatry is or is not. It may be data about how well a particular clinician can channel Mr Spock, but most doctors have more Dr McCoy in them. 😉

Once those feelings are triggered, then motivated reasoning can fill in explanations to justify those feelings. The feelings came first, the justifications came second. This is true of all denialism. The justifications are always long on how evil those in the group the denialists are against and short on facts that are compatible with a new way of putting all the facts together.

Bentall mentions Wagner-Jauregg’s Fever therapy, but does not appreciate how important an advance it really was, and does not appreciate the careful scientific research behind it. Yes, the science was crude by today’s standards, but it was state-of-the art at the time. It did save many thousands of lives. Fever Therapy was the “standard of care” for a couple of decades. It fell out of use because penicillin worked just as well, was a lot cheaper and was a lot safer (Fever therapy had a death rate of ~10-15%, but the disorder it was used to treat (neurosyphilis) was 100% fatal).

Thanks again for the thoughtful post and blog link…. now I have even more reading to do!! I am never gonna finish re-reading my Feynman lectures at this rate.

One quick point… Szasz and others do not consider themselves to be anti-psychiatry. (Szasz referred to this in his book ‘Anti-Psychiatry -Quackery Squared’) I also do not like to be called a denialist. Of course the conditions that are called ‘mental disorders’ exist. I just am skeptical of the current medical biological paradigm. This afternoon I have been exploring the views of Dr Sapolsky and also Andrew Beck, on the idea that by age 5 there is already a correlation between socio-economic status and the thickness of the frontal cortex. Maybe Ritalin is the only answer.

What I am unclear in sifting through these posts Dirk, is what you or “skeptics of the current medical biological paradigm” would do to aleviate the symptoms of folks suffering from these “mental disorders”…? Sorry if I missed this from another post….

1. Agree or not: There is a brain abnormality, regardless of how it comes, that causes people to have hallucinations.

Hallucinations result from the functioning brain. ‘Abnormal’ is an imprecise term. Some psychonauts seek this out. My overiding concern is that help should be given to those that suffer but based on scientific evidence. And not forced or even coerced.

2. Agree or not: Having hallucinations is bad for you.

Yes if they cause suffering to that person. (St Paul didn’t do too badly!) In some cultures having hallucinations is considered to be part of a spiritual enlightenment. Not a stigma or derogatory ‘label’.

@PharmD28 Dirk will be “skeptical” of the treatment for the disorder until a case is made for the treatment, at which point he’ll be “skeptical” that there is a disorder to treat (as he has been this entire thread). Making the case that there is a disorder to treat will lead him to be skeptical of the treatment, guess what making a sound case for the treatment will result in…

I thought we knew “little or nothing” about the “mind/brain”? And having said that, asking to only treat those who “suffer based on scientific evidence” after admitting that we know squat about the mind/brain is a bit of an odd expectation…it would reason that from this line of logic, no one with reported “psychiatric” symptoms would nearly ever recieve treatment?

Having hallucinations is bad for you “if they cause suffering to that person”….

I suppose I never really gave much play to the idea that people that walk around hallucinating, or my mother asking us to dig the bodies up from the yard, perhaps she was not suffering…but at some point I got tired of digging the hole for her…and the family got quite distressed…guess that was their problem…

“In some cultures having hallucinations is considered to be part of a spiritual enlightenment.”

‘spiritual enlightenment’ is an imprecise scientific term I think you would agree 😉

On display here is the disingenuousness of your arguing. CLEARLY I am not referring to people who are dropping acid or sweat lodging or any of that, per the subject at hand. CLEARLY I am referring to hallucinations that are involuntary, per the subject at hand.

You could have answered my question by prefacing that, “Other than those seeking out such experience…”, if you felt it needed mentioning (it didn’t), but instead you took the weaselly way out, a rhetorical dodge.

I’ll ask one more time. If you sieze on irrelevant unspecified details to dodge I will not bother with you anymore:

Do you believe that there are conditions of the brain that lead to INVOLUNTARY hallucinations that the hallucinator does not want?

‘What I am unclear in sifting through these posts Dirk, is what you or “skeptics of the current medical biological paradigm” would do to aleviate the symptoms of folks suffering from these “mental disorders”…? Sorry if I missed this from another post….’

No… this is the first time I have been asked. Firstly, do no harm. The history of psychiatry is littered with treatments such as lobotomy, insulin coma therapy and ECT which have done more damage than good. You can see the results of iatrogenic disasters such as the injudicious use of anti-psychotics here. http://www.youtube.com/watch?v=W_3bbpFjI68

Secondly, recognise that the DSM, with its definitions of such conditions as Multiple Personality disorder or even Oppositional Defiant disorder, is scientifically spurious. Even schizophrenia has become a stigmatising label which has no obvious benefit to the alleviation of suffering. Are psychiatric ‘disorders’ the result of the medicalisation of deviance or have they been proved to be a bona fide biological abnormality? Does MDD stem from environmental stress or does it have a primary genetic cause? I am just skeptical of certain claims.

Dirk Steele on 18 Apr 2012 at 7:13 am
But even you, Dr. Novella, as a scientist and skeptic still subscribe to the belief in ‘diseases of the mind’, which Thomas Szasz pointed out, over 50 years ago, was a metaphorical statement and had no scientific basis.

# Dirk Steele on 18 Apr 2012 at 3:07 pm
Szasz would point out the very concept of a ‘mind disease’ or mental ‘health’ or ‘hygiene’ of the mind is not a scientific concept. It is a metaphor.

“what you or “skeptics of the current medical biological paradigm” would do to aleviate the symptoms of folks suffering from these “mental disorders”…? ”

To quote Szasz ‘Before we can even begin to try to understand what causes a baffling and troubling phenonemon or how we may change and remedy it, we must be sure of what it is.’

Up until the 1980s, psychiatry viewed homosexuality as a ‘mental disorder’. Many people, Alan Turing for example, were given ‘wonderful’ psychiatric treatments.

Even today, psychiatry cannot decide, after months of tests, whether Anders Breivik is a paranoid schizophrenic or is sane. What ‘treatment’ should he be given?

Is the cause of ‘ADHD’ a biological brain disorder to be treated with stimulants and potentially toxic drugs or is it, as many believe, the result of a ‘sick’ school environment which is not conducive to certain children? (As per Sir Ken Robinson on Tedtalks.)

If you had any knowledge of the views of those called ‘deniers’ you would have the answer to your question. What is your easy solution then?

@Dirk
“psychiatry cannot decide, after months of tests, whether Anders Breivik is a paranoid schizophrenic or is sane.”
They can’t decide if he is ]legally’ punishable with prison for a crime, or to be sequestered in a nuthouse for everyone’s protection. He can be designated as mentally disordered either way.
You need to come up with some better analogies. There’s a certain amount of disorder indicated there as well. Maybe it’s cultural or simply tactical, but it’s not working for you.

I read your blog entry on xenophobia with interest and agreement. Regarding the relationship with psychiatry, I think I come to the opposite conclusion. I feel that feelings of xenophobia share roots with psychiatric practise, in that certain sections of a society are uncomfortable with those citizens that do not conform to ‘defined’ societal norms of behaviour. Thus attempts are made to disempower or marginalise those individuals – which psychiatry does by attempting to show that they have a proven medical biological brain disorder. Causing great personal stress in the process.

I also found it interesting that you refer to Feynman’s idea of cargo cult science. Did you know he referred to psychiatrists as witchdoctors? I think he may have influenced Szasz a little – and that resulted in the book ‘The Manufacture of Madness – A comparative study of the Inquisition and the mental health movement’ (One of Szasz’s best books in my opinion)

So I will try now to doubt my ToM a bit more. But I will not stop asking the questions….

So Dirk Steele, you like St. Paul, marijuana, and homosexual sex. Szasz is your Christ figure and you are quoting him as if his writings are your New Testament. Culture and laws will not crumble for this man of mythic proportions. Euphoric interpretations only aid you to see unicorns crossing your keyboard.

‘They can’t decide if he is legally’ punishable with prison for a crime, or to be sequestered in a nuthouse for everyone’s protection. He can be designated as mentally disordered either way.
You need to come up with some better analogies.’

Not true. If he is designated as having a mental ‘disorder’, i.e schizophrenia, he can be detained for life. If he is sane then 21 years is the maximum sentence. (Although there are other legal strategies that can be employed to increase his incarceration.)

So… is he a paranoid schizophrenic or not? Have you followed this debate in detail?

‘So Dirk Steele, you like St. Paul, marijuana, and homosexual sex. Szasz is your Christ figure and you are quoting him as if his writings are your New Testament. Culture and laws will not crumble for this man of mythic proportions. Euphoric interpretations only aid you to see unicorns crossing your keyboard.’

Thank you for your insights and contribution. Others that I greatly admire include Darwin, Einstein and Popper. Oh yes and those pesky unicorns.

What’s not true? Who said anything about the length of incarceration or sequestration here? You’re mixing up a legal definition of criminality with a psychiatric definition of disorders.

He’s likely to be an extreme example of a criminal psychopath, in which case he’ll be considered sane. Does that mean to you that he has no mental defects? It would mean to a psychiatrist that he has, but one that they not yet have a treatment for.

‘You’re mixing up a legal definition of criminality with a psychiatric definition of disorders.’

If one is considered to have a mental ‘disorder’ one cannot be held criminally responsible. In Breivik’s case this is especially interesting because the prosecution are trying to prove his insanity while his defense argues for his sanity. Normally the opposite stance is adopted.

‘Does that mean to you that he has no mental defects?’

Define a ‘mental defect’ as Szasz would ask. Until you can I cannot answer the question.

I gotcha so you’re dodging the question. If you don’t know, or at least consider, that what I could better have described as violent psychopaths have mental defects, then I can’t answer the question that you should, by using your own definition, answer for yourself.

Dirk, the terms “sane” and “insane” are legal terms, not medical or scientific terms. The proceedings that are going on are legal proceedings, not scientific ones. They will come to legal conclusions not scientific conclusions. Humans have a legal system as a way of limiting the power of violence to the State, and to provide some checks and balances to the humans who are designated to carry out the social system of laws. Unfortunately some people want to use the power that the State has and use it to enforce their own crazy ideas.

A great many evil things have been done with a great many justifications. Science isn’t about justifying behaviors, science is about asking questions and understanding reality.

Human ancestors didn’t evolve gigantic brains so as to have sane thoughts. Humans evolved our gigantic brains because they promoted greater survival and reproduction. Some of the “features” that those gigantic brains have are useful in some circumstances and non-useful in other circumstances. The problem is that we can’t get to pick-and-choose what state our brains will be in because if organisms could do that, they would trigger euphoria and not do anything else.

There are circumstances where triggering euphoria is a great survival feature, as when you are being chased by a bear and to stop running because you are tired is certain death. Under those circumstances, being able to run yourself to death is a “feature”. Under circumstances where one is not running from a bear, a similar state of euphoria can be mania or hypomania. Mania while running from a bear is a “normal” response to near death metabolic stress. Mania while not running from a bear is a dangerous condition to be in because you can easily die and so it needs to be treated.

The continuum fallacy mentioned previously is at the heart of this debate. At what point does deviation from the norm become a disorder? This applies to most psychiatric conditions, but we certainly see it in neurological conditions as well. For example, at what point does a person with memory loss suddenly become demented? Even if you have some sort of biological marker like a finding on a scan or laboratory test, the medical community has to come to a conclusion about what constitutes a positive, negative, or inconclusive test result. At what point does being moody become bipolar? Inattentiveness become ADHD? Altered reality testing become schizophrenia? I don’t think most of us, Dirk probably included, would argue that there is not a clear difference between the extremes in those examples, but where do you draw the line? Psychiatry just has a harder job than other medical disciplines when it comes to quantifying the traits of their group of conditions.

No. I do not understand what you mean by the term ‘mentally defective’ in this case. You have to define it so that I can understand what you mean. Only then we can debate. Is it so difficult for you to explain?

It seems to me that you are swinging between scientific, legal, colloquial, medical, psychiatric and standard English definitions in your comments. A good example is disease/disorder/illness that you have used at various times.

When others do the same, you chastise them, for example when you ask cwfong for a scientific definition of “defect.” To me, and I suspect to all the readers and commenters of this blog, “defect” is part of a range of words including disease/disorder/illness/defect. There are others that one could also include depending upon upbringing and education.

cwfong is asking a perfectly clear question but using a colloquial term that has a scientific definition that exactly matches words that you have already used. Asking for a definition comes across as you evading a perfectly clear question.

Accept that you are not the only person with a thesaurus and answer questions rather than dodging them.

Dirk, I didn’t mean to confuse you by substituting defect for disorder. In any case I’m satisfied that you won’t provide us with a definition of either. You’re a denier rather than a provider of what scientists to date have found the most reliable.
It’s easy, you don’t have to think, just play a child’s game.
Like pretending it’s about deniers and conformers, leaving out the thinkers entirely.

Of course you know what I mean. If he doesn’t have a mental defect or disorder, then nobody does. I should qualify that to say that he ‘probably’ has a mental defect, or disorder or disease, since who knows, perhaps all those children deserved to be killed and he’s the only one that was normal enough to realize it. Please explain if you think I’m wrong.

I think you are hung up on teleology. Because there is no teleology, then nothing is not normal because nothing is “suppose to happen”. so what ever does happen is “normal”. That is semantics and sophistry.

What does this have to do with science and/or psychiatry?

It is very rare for humans to kill many other humans. Many people go through their whole lives never having killed someone. There are human instincts that make killing other humans difficult in some circumstances. Humans have found it convenient to attempt to deter humans from killing other humans in many circumstances. This helps with maintaining a civil society. This was determined before the scientific method had been worked out, so it wasn’t really a scientific finding.

When people are unable to make themselves fit in with society, they are considered to have a deficit or defect. It is much like my analogy of a “theory of mind” that is necessary for communication. If a person has a “theory of mind” that does not match the “theory of mind” of any other individual, that person will be unable to communicate with anyone. Since the function of a “theory of mind” (in the sense that I am using the term) is to be able to communicate with other humans, a “theory of mind” that is unable to be used to communicate with other humans is defective.

If someone is unable to match their behavior with what society demands, there is a problem with either society making unreasonable demands, or with the individual being unable to meet those reasonable demands. Refraining from killing scores of people is not an unreasonable demand. That someone is unable to do so indicates a defect in their ability to restrain their behavior.

It takes an entire causal chain to bring about such an action. That action could have been inhibited at any point along that causal chain. That action was not inhibited, therefore there is a defect at each checkpoint along the causal chain.

daedalus2u,
I don’t know if that teleology sermon was directed at me or Dirk, but either way it misses the point.
If teleology is the explanation of phenomena by the purpose they serve, rather than by postulated causes, it may be Dirk’s perception here that Anders Breivik, in thinking he was serving a legitimate purpose, was therefor normal, but it’s not mine. In any case, all phenomena ARE better explained by examining the purposes they were meant to serve, and if that purpose was in some way a fantasy (as in this case) then we have some evidence of a possible disorder.
“In the pragmatic way of thinking in terms of conceivable practical implications, every thing has a purpose, and its purpose is the first thing that we should try to note about it. Charles Sanders Peirce”

So in your case, if you’ve just demonstrated a failure to draw the proper inference from my remarks, it may be due to difficulty with the inductive thinking process. Is that a defect? You tell me.
This little homily about defects all along the causal chain is also so much nonsense. The same defect will be the cause of multiple effects.
As to your lecture on the impracticality of mass murdering, I think we all recognize its anti social aspects. The question then should be, why would a member of the society see reason to flout those rules without our very normal empathy deterring him and very practical fear of consequences eluding him.

im still a bit confused….sorry, I am one of the slower minds on this site….perhaps I have some psychiatric defect 🙂

Anyway…you stated earlier that you acknowledged that there are people that involuntarily suffer from things like hallucinations. You state that we have no real idea why. And you state that treating them is at this point impossible or futile because we have no idea of the cause.

You then ask me “What is your easy solution then?”

Well, my mother when she was psychotic, delusional, and acting “crazy”….she was admitted to the hospital…yes under the care of “pseudoscientists” and sense then she did significantly better and I was not digging up bodies in the yard and was not flipping out in the middle of the grocery store and calling the police department daily asking them paranoid probing questions.

Now does this prove the cause of her issues? Does this suggest that this is the very best interventions for her problems? Did they harm her or label her permanently creating a path that was worse than doing just nothing?

I could be critical of her treatment to date in a number of ways and I can hypothesize about what improved diagnosis and treatments she would benefit in say 200 years from now……but for now I have a very difficult time understanding how your do nothing stance in the name of your superior scientific views would have done the patient anything but have severely worse outcomes…..

It would appear that you are simply denying a significant problem in those that suffer and you are in denial about treatments that are being used to alleviate this suffering and the evidence that supports these treatments more or less…..the categorical stance that those that suffer should not seek out psychiatry/psychology because it is pure pseudoscience seems so very impossible for me to even try to accept….I guess I will never understand your way of seeing this….

It was fun seeing if either I could understand your angle and/or trying to persuade you in the process….neither seems feasible so far and I see no light at the end of the tunnel – farewell

‘Did they harm her or label her permanently creating a path that was worse than doing just nothing?’

No-one is suggesting doing nothing. There is a great debate between those such as Szasz and Bentall, and those that would define the condition as a proven medical biological brain abnormality to be treated with sedative anti-psychotic drugs (although these may be helpful.) The work of Loran Mosher is an example.

Dirk, how about this example. If you take an infant and never expose them to language, they never develop the ability to utilize language. This is the normal occurrence when there is lack of exposure to language, Is there a mental defect or disorder or deficit in this case?

cwfong it was directed at Dirk, and not at you. However if the shoe fits, wear it.

There is no evidence for teleology. Some humans perceive there to be teleology because of their hyperactive agency detection. This is a false positive. The erroneous detection of something that isn’t present.

It is extremely common for humans to perceive teleology, so in that sense it is “normal”, however it is imaginary. That so many humans persist in a belief in teleology is good evidence for how strongly beliefs can influence perceptions.

The “observation” of teleology is a cognitive illusion, like an optical illusion. It comes from a defect in human cognitive neuroanatomy that hyper-prioritizes detection of agency. Hyperactive agency detection is useful to detect and escape from predators, but it is not useful in trying to understand reality.

(note: I left this comment on the previous blog post, it was supposed to be on this one – sorry)

I’ve never commented on this blog before and I’m a bit hesitant to start here but I did want to add my two cents. Mainly I keep quiet because I dislike the often nasty nature of blog comments. It seems that if a troll pops up on a blog, it gets bloody. Two things usually pop to mind, “Off with his HEAD!” is one. The other is the scene from Mary Shelly’s Frankenstein. Not that Dirk encapsulates Frankenstein in all ways but just the general, chase-the-monster-out-of-town-with-torches-and-pitchforks scenario. I like this blog very much so please don’t misconstrue my comments here.

I am a pharmacist, going on 15 years now. I see the prescribing end of psychiatric disorders. So for Dirk’s point that he feels we are giving our children too many drugs (namely for ADHD) that may very well be toxic, I agree. Take for instance a five year old at my pharmacy on 15 mg of amphetamines – I find this hard to stomach. Never mind that this child has been on amphetamines for quite a few years now. I see too many children on amphetamines. It has exploded. We order Adderall XR, Metadate CD as well as generic Ritalin, Adderall and Concerta contantly. We have a hard time keeping it in stock. It is mostly children under the age of eight who are on the receiving end but quite a few young teens as well. These are highly addictive drugs. Amphetamines are easily abused and in many cases cause sleep disturbances and weight loss or lack of weight gain.

Do I believe ADHD is an actual disorder, yes. Do I think we should know more about it before we freely advocate such blanket use of highly addictive drugs to our children. Yes. When we put these children on these drugs at such a young age, when is it appropriate to take them off? Is it the notion that one day they will wake up and no longer have ADHD? Most likely not. Most five year olds become fifteen year olds who take amphetamines – only at much higher doses due to tolerance. I am an educated person but neuroscience is not my specialty. So perhaps someone can explain to me that if executive functions lie in the frontal lobe and we know that the frontal lobe is the newest part of the human brain (in terms of evolution) therefore the slowest to develop in a growing human (children therefore have a hard time with logic and seeing things to their conclusion) how do we not wait until these children are older to allow their brains to develop without the interventions of drugs to see if there is truly an issue. Some children may need behavioral intervention, not pharmaceutical intervention. These days, in general, it is not the case. It is easier to give ourselves and our children a pill rather than to try other interventions first. Do I think this is partly due to pharmaceutical companies pushing their own agenda? Yes. I believe we need to be wary of this current trend.

So of course I don’t advocate doing nothing, I just think we should question these things. We should allow people like Dirk to share their doubts. Just as vaccine deniers should have the right to share theirs (and this is from an immunizing pharmacist). I believe that the best way to educate someone is not to berate them even if they are using a obnoxious “tone” in their comments but to simply try and explain to them why you don’t agree with some good evidence. Then move on. I don’t think there are too many people that have been swayed to another way of thinking by engaging in this type of back and forth discussion on blogs and the like, so in general it is best not to waste your energy.

There is a definitive answer to the Bleivik case. Using Mr. Steele’s favorite philosopher, Popper to moralize, the youth killer in Norway would be seen as criminal because of his intolerance. Popper promoted tolerance in a country to include intolerance only to the point where tolerance as a concept would self-destruct as a logical end of intolerance.

daedalus2u,
Thanks for another silly lecture that’s way off the mark. Teleology is not restricted to it’s theological usage. I repeat: “If teleology is the explanation of phenomena by the purpose they serve, rather than by postulated causes,” then there are legitimate purposes to be served by humans that aren’t acquired by direction of some supernatural agency. Or by an infusion of NO for that matter. But those purposes you favor that are acquired in the thrust of xenophobia might fit in here.

Well there is a language deficit/defect for sure! Using the term ‘mental disorder’, because of it’s connotations, is more problematical. This condition is not to be found anywhere in the DSM which is the psychiatric bible of mental illness. Does a mute person suffer from a mental disorder for example? Did Helen Keller have a mental illness? What I do not accept is that it is a medical biological psychiatric disorder which can be cured using psychiatric drugs. I do not accept that ADHD is a valid medical mental illness/disorder either. By referring to Szasz as a ‘mental illness denier’ Dr Novella actually obscures his full message. He does not deny that the conditions which are called mental illness do not exist. Szasz has a greater intellect than mine so I do at times struggle to give proper justice to his ideas.

‘Of course you know what I mean. If he doesn’t have a mental defect or disorder, then nobody does. I should qualify that to say that he ‘probably’ has a mental defect, or disorder or disease, since who knows, perhaps all those children deserved to be killed and he’s the only one that was normal enough to realize it. Please explain if you think I’m wrong.’

I think you are wrong. By using the term ‘mental defect’ do you mean that his brain is abnormal? He has a chemical imbalance perhaps? Or do you see his political ideology and his actions the result of a ‘mental illness’? Do you think that the persons that carried out 9/11 were suffering from a medical disorder? Define ‘normal’ and where you think the boundaries into abnormality are? US soldiers are often asked to commit acts of multiple killings of human beings in war. Do they suffer from a mental defect? Breivik viewed his actions as necessary in his war against multiculturism in Europe. Psychiatry cannot even agree if he suffers from schizophrenia or if he is sane even after months of study. What does this show about psychiatric diagnosis?

@Dirk,
“I think you are wrong. By using the term ‘mental defect’ do you mean that his brain is abnormal?”

The ‘behavior’ is abnormal in the society where he is expected to function. It could be the result of a physical abnormality, or the result of environmental causes. Sociopaths for example are both born and made. I won’t attempt to go into the literature on the subject, although there isn’t that much of it, as they seldom submit to psychiatric or psychological examination = most of the research is done with the criminal population of sociopaths who are more or less forced to submit to such examination.

“Do you think that the persons that carried out 9/11 were suffering from a medical disorder?”

Not necessarily, although those who volunteer for suicide missions may have fanatical delusions.
Your analogy as usual is bad, since again, they are acting in accordance with the needs their society wants to see fulfilled. Just as our, or any, good soldier acts to satisfy the dogs of his particular war.

Breivik convinced himself that he had a mission to fulfill as a warrior for a fantasy army. Most sociopaths aren’t that deluded. So wherever that leaves him in the lexicon of misdiagnosis, he’s still a certifiable looney.

Dirk, we are talking about medical diagnosis here, not connotations put on medical terms by non-medical professionals.

People can be mute for multiple neurological reasons. People who have changes in their speech for what appear to be neurological reasons need to be examined and treated. Dr Novella has discussed some cases, for example people who appeared to acquire a foreign accent.

Some languages do not contain certain sounds. Native speakers of those languages have difficulty using those sounds when they learn other languages. A classic example is the “el” sound in Japanese.

Multiple things can cause speech difficulties, and some of them can be treated with drugs. For example hypoglycemia associated with diabetes can cause slurred speech and if severe enough can make people mute. Hypoglycemia can be treated with drugs. A person may also have learned to speak with an accent that sounds like slurred speech. That is not something that can be treated with drugs. How does a treating psychiatrist differentiate them? By doing a differential diagnosis.

If psychiatry is a pseudoscience, then how can it do a differential diagnosis and tell the difference between slurred speech due to stroke, hypoglycemia, and lifelong non-exposure to speech? How can effective treatments then be given?

You mention US soldiers killing in war. There was a documentary movie I saw about it which discussed the changes in training that US soldiers have received since WWII. In WWII, most US soldiers did not kill enemy soldiers. The killing was done by a relatively small fraction of the soldiers in the battle. Killing is simply too difficult for many people because of the normal human aversion to killing another human.

Modern soldier training has been able to over-ride that natural aversion to killing. Modern soldiers (Iraq war era) are very different than those in WWII, the Korean war, or even Vietnam. The difference is not the weapons, it is the training.

Unfortunately, there are side effects of this training, soldiers get PTSD and can’t turn off the over-ride of the normal aversion to killing another human being produced by training. The military industrial complex doesn’t care about the soldiers, all the MIC cares about is profits for military contractors. That is why the VA and the military have been PTSD denialists. It is like Catch 22.

PTSD can be treated. It is not a something that is “cured” by a pill. It requires neuronal remodeling to undo the over-ride of the aversion to killing people that the training produced. It will very likely take as long or longer to restore the aversion to killing people as the training took to produce that over-ride in the first place.

It is easy for denialists to ignore something like PTSD, and they do. Usually for self-serving, profit motivated reasons. Often chicken-hawks are PTSD denialists too.

In the wikipedia piece on anti-psychiatry, it states that Szasz says he adopted his views from his Libertarian political beliefs and not from an examination of patients.

“Szasz has indicated that his own views came from libertarian politics held since his teens, rather than through experience in psychiatry; that in his “rare” contacts with involuntary mental patients in the past he either sought to discharge them (if they were not charged with a crime) or “assisted the prosecution in securing [their] conviction” (if they were charged with a crime and appeared to be prima facie guilty); that he is not opposed to consensual psychiatry and “does not interfere with the practice of the conventional psychiatrist”, and that he provided “listening-and-talking (“psychotherapy”)” for voluntary fee-paying clients from 1948 until 1996, a practice he characterizes as non-medical and not associated with his being a psychoanalytically trained psychiatrist.”

That pretty clearly makes Szasz a non-scientist. If a belief is not grounded in data, then it not science. Deriving beliefs from political beliefs is pseudoscience.

“Psychiatry cannot even agree if he suffers from schizophrenia or if he is sane even after months of study.”
Again, that’s not at all a question of whether his behavior was or was not abnormal. It’s a question of whether he’s to be held legally responsible for his aberrant behavior. Do you not really know the difference, or are you simply playing a debating game? Or both?

‘If psychiatry is a pseudoscience, then how can it do a differential diagnosis and tell the difference between slurred speech due to stroke, hypoglycemia, and lifelong non-exposure to speech? How can effective treatments then be given?’

In all these cases psychiatry does nothing. The DSM states nothing about these conditions. Psychiatrists do not treat strokes or diabetics. Neurology and scientific medicine perform the differential diagnosis. Psychiatry has another agenda. If, for example, any psychiatric disorder is found to have a neurological basis, such as neurosyphilis or epilepsy, it is immediately removed from the field of psychiatry. Neurology is the medical discipline that treats diseases/disorders of the brain. Psychiatry is concerned with diseases of the mind. Since the mind is not a thing and cannot be objectively measured – psychiatry is a pseudoscience.

‘It is easy for denialists to ignore something like PTSD, and they do.’

Who does? No-one that I know. The discussion is over whether this is a bona fide medical issue concerned with curing a pathological disorder. The debate is over how this condition is treated. ‘Crazy Like Us’ (forget who wrote) is a book that explores how the west is exporting a cultural bias to third world disaster areas which is causing more harm than good.

As far as I know, Szasz has never claimed his own views are scientific. Only that psychiatry is a pseudoscience akin to astrology. His mate, Popper, agreed.

Neurology is the medical discipline that treats diseases/disorders of the brain. Psychiatry is concerned with diseases of the mind. Since the mind is not a thing and cannot be objectively measured – psychiatry is a pseudoscience.

To deny the existence of the mind is to prove the rule with one’s own exception.

In a wonderful example of Jungian synchronicity, I am at this moment watching the film ‘One Flew over the cookoo’s nest’ on the good old BBC. It still remains the most accurate portrayal of psychiatry captured on celluloid.

So you think that the mind is a thing. An object. You can hold it? You can look at it under a microscope?

Ignoring your straw man in the second sentence, I will just note that you obviously don’t apply the same juvenile arguments to language, or else you wouldn’t be here saying all of this dumb stuff. You clearly believe that words are real and language is a valid subject. What about illiteracy? Is that not a problem to be treated? Do you believe that only ink and paper manufacturers are the only ones engaged in a valid practice? Is teaching people to read and write a pseudoscience because words aren’t physical objects?

@Dirk,
“Neurology is the medical discipline that treats diseases/disorders of the brain. Psychiatry is concerned with diseases of the mind. Since the mind is not a thing and cannot be objectively measured – psychiatry is a pseudoscience.”

If the mind is not a “thing” what is the intellect that you seem unduly proud of?
(I won’t ask about the logic that’s gone missing, since you might not have had enough of it to lose.)

What about illiteracy? Is that not a problem to be treated? Do you believe that only ink and paper manufacturers are the only ones engaged in a valid practice? Is teaching people to read and write a pseudoscience because words aren’t physical objects?

Not medically treated no. Do you think that it should be? The DSM states that difficulties with mathematics is a mental disorder. Which psychiactric drug do you recommend for the cure?

Last time I looked.. most words were physical objects. Either in soundwaves or on paper in ink for example. But I do not understand what you are trying to tell me here.

No, but it’s the property of a physical object. You, for example, mentioned intellect. Do you see that as the property of a physical object, or an independent object, or if not a thing, as somehow an effective essence with no thing at all involved? Whatever the case, you seem to give it some importance, especially when some-thing, of whatever intellect consists of, is lacking.

” Dirk Steele So you think that the mind is a thing. An object. You can hold it? You can look at it under a microscope?”

‘Ignoring your straw man in the second sentence, I will just note that you obviously don’t apply the same juvenile arguments to language’

My second sentence was ‘An object’. Where is the straw man in that? Do you actually know about the English language? You know.. grammar, punctuation, sentence construction and all that difficult stuff?

‘I dunno, hallucinations are caused by the brain and are pathological.’

You need to cite the scientific evidence to support this view. Please do. If you think that the mind is the brain you may not be aware of cognitive science. For example David Chalmers and Andy Clark speculate that the mind can extend itself outside of the body. Read ‘Supersizing the Mind’ It is impossible for the brain to do that unless your mind is so open that your frontal cortex seeps out of your ears. (a little joke there…) What do you think?

Penrose said, “I think I would say that the universe has a purpose, it’s not somehow just there by chance … some people, I think, take the view that the universe is just there and it runs along–it’s a bit like it just sort of computes, and we happen somehow by accident to find ourselves in this thing. But I don’t think that’s a very fruitful or helpful way of looking at the universe, I think that there is something much deeper about it.”
You have a problem with that?

Anyway…. the numbers of comments on Dr Novella’s views is beginning to give more credence to his ideas/blog than he deserves. So I will stop now. Anyone wishing to debate further can send me their comments to skepticalpsychiatry.com or nick@nickstuart.com. Please read http://en.wikipedia.org/wiki/Anti-psychiatry first so that you understand the positions that individual psychiatric skeptics adopt. My final quote is ‘Science must begin with myths and the criticism of myths.’

‘Penrose said, “I think I would say that the universe has a purpose, it’s not somehow just there by chance … some people, I think, take the view that the universe is just there and it runs along–it’s a bit like it just sort of computes, and we happen somehow by accident to find ourselves in this thing.

But I don’t think that’s a very fruitful or helpful way of looking at the universe, I think that there is something much deeper about it.”

Dirk, no drugs were used to induce PTSD, why do you feel there is a necessity for drugs to be used to treat PTSD in order for the treatment to be “scientific”?

When people lose mathematical ability due to a stroke, they are given a medical treatment called rehabilitation. When a person never acquired mathematical ability they are given an educational treatment called teaching. Both of those treatments amount to mostly talking with the subject. Are they “medical” treatments? One is, and one isn’t.

The “treatments” may be identical, one is to cause neuronal remodeling to recruit other neuroanatomy to produce mathematical ability lost due to a stroke, one is to cause neuronal remodeling to produce mathematical ability that was never present.

Drugs can facilitate the neuronal remodeling that restores mathematical ability. Is using drugs to do so pseudoscience?

The brain is an organ. It runs on chemistry. Chemicals affect how the brain operates. What is non-scientific about using chemicals to alter the functionality of the brain?

You have presented nothing that counters Dr Novella’s characterization of you as a denialist. All your arguments seem to be from incredulity. That because ADHD has increased prevalence now compared to 20 years ago, that the difference must be due to malfeasance on the part of psychiatrists.

The death rate from Alzheimer’s has gone up too. In 1980 the death rate for Alzheimer’s was ~0.3 per 100,000 population. In 2007 it was the 6th leading cause of death with a death rate of ~22 per 100,000. That is an increase of ~70 times. Is that change due to malfeasance on the part of psychiatrists?

There was no diagnostic test for Alzheimer’s until quite recently. There is no treatment for Alzheimer’s. Does that mean that a diagnosis of Alzheimer’s is pseudoscience?

I don’t understand by what basis you think that psychiatry is a pseudoscience. If Szasz has no scientific basis for his claims that psychiatry is a pseudoscience, then by believing his non-scientific claims you are being a denialist.

It is just like creationists. Denial of science for non-scientific reasons. The analogy to astrology is not apt. There are scientific reasons to doubt the claims of astrologers.
The brain is an organ. It runs on chemistry. Chemicals affect how the brain operates. What is non-scientific about using chemicals to alter the functionality of the brain?

You have presented nothing that counters Dr Novella’s characterization of you as a denialist. All your arguments seem to be from incredulity. That because ADHD has increased prevalence now compared to 20 years ago, that the difference must be due to malfeasance on the part of psychiatrists.

The death rate from Alzheimer’s has gone up too. In 1980 the death rate for Alzheimer’s was ~0.3 per 100,000 population. In 2007 it was the 6th leading cause of death with a death rate of ~22 per 100,000. That is an increase of ~70 times. Is that change due to malfeasance on the part of psychiatrists?

There was no diagnostic test for Alzheimer’s until quite recently. There is no treatment for Alzheimer’s. Does that mean that a diagnosis of Alzheimer’s is pseudoscience?

My second sentence was ‘An object’. Where is the straw man in that? Do you actually know about the English language? You know.. grammar, punctuation, sentence construction and all that difficult stuff?

If you want to be pedantic about language, “An object.” isn’t even a sentence. I was assuming that you actually meant to form words into language, and I granted that you may have meant for it to be joined to the first sentence. It is a straw man because you are clearly trying to imply that I believe the mind to be an object, and then you argue against that.

Even with all of the insults hurled at you here, you still have been given more respect than you deserve.

Maybe loving to debate is a problem because you might not be seeking the truth. Your purpose is to oppose what the other person says instead of actually considering that you might be wrong and exploring the other viewpoint honestly.

As cwfong said (credit where it’s due!), the mind is not a physical object but a property of a physical object, which means that the mind is physical.
(At least that has to be the default assumption until an actual instance of a the non-physical is discovered)

“David Chalmers and Andy Clark speculate that the mind can extend itself outside of the body. ”

Yes, pure speculation with no evidential support.
The default position holds in the meantime.

Penrose: “I think I would say that the universe has a purpose, it’s not somehow just there by chance … some people, I think, take the view that the universe is just there and it runs along–it’s a bit like it just sort of computes, and we happen somehow by accident to find ourselves in this thing. But I don’t think that’s a very fruitful or helpful way of looking at the universe, I think that there is something much deeper about it.”

cwfong: “You have a problem with that?”

Oh, just his qualifiers: “I think”, “I would say”, ” I don’t think”, “I think”.
In fact, nobody actually knows.
Buit there is no evidence or reason to think there is purpose. Evolution is adequately explained without the need for purpose. Even adaptive mutation is a form of (accelerated) random mutation and non-random natural selection. I know this has been put to you before, but you have never responded to that explanation in any meaningful way – so here’s your chance, should you choose to accept the challenge.

Thank you, dr. Novella
Recently my little brother was diagnosed with ADHD. He was always very lively but also smart and interested in various sciency things, so the diagnose caught my family by surprise. I struggled with it, because it seemed so bad to use drugs to adjust him to school. But in the last weeks i came to term with it. This blogpost and the comments made a few things clearer to me. Thank you very much!

The thing about the prefrontal cortex made me think of two things:
1. The marshmellow test. Does it test the EF in children? Do ADHD children perform worse?
2. Phineas gage. Did he have ADHD-like symptoms?

I would love to read some more about ADHD and other brain stuff, because you inspired me (in part) to gravitate towards a master in neurobiology.

I am back! I must be a true denialist eh? Well I was diagnosed with mild depression last night…

Anyway I have been thinking about something that Dr Novella raised earlier… that gave me pause for thought – or as some might say – abnormal brain activity.

‘Do you doubt the reality of migraines? If not, then you are inconsistently applying your criteria – arbitrary criteria meant to cast doubt on mental illness, and not based on an actual understanding of modern neuroscience. ‘

Now I am an old geezer who has ‘suffered’ for many many years with what I have now discovered to be called ‘silent migraines’. Generally my symptoms are visual hallucinations, zigzags et al. But I never get pain. Funnily enough I never get headaches from my over consumption of whisky either which could be considered a drawback as well a benefit. Symptoms of silent migraines also can include auditory hallucinations but I have not taken much notice of those voices. Epilepsy is a related syndrome I believe.

But my question to Stephen, or any other volunteer is… How are mental disorders shared between neurology and psychiatry? Migraines, epilepsy (now – but not in the past when they were incarcerated), even strokes are not the province of psychiatry and, I assume, neurologists, understandably, steer clear of the personality disorders. But who makes this choice? Why? I think I need to understand this more. Thanks.

“But who makes this choice? Why? I think I need to understand this more.”

The choice is personal and cultural. An internist can legally perform heart surgery but no heart surgeon will have his back in court when something happens. Similarly a psychiatrist can treat neurological pathology but you’re kinda stepping on neurologist feet and won’t be backed up in court if harm is done. Not only that but a good physician doesn’t reach out of the purview of his field to any great extent and if he does and starts treating then the physicians he has to spend his life with will look down on him.

However, the demarcations lines that create a specialists ‘purview’ are fuzzy, but it would be a false spectrum to say they don’t exist.

‘However, the demarcations lines that create a specialists ‘purview’ are fuzzy, but it would be a false spectrum to say they don’t exist.’

So are you saying that other cultures have a different or ‘personal’ choice over whether a disorder can be treated by a neurologist or a psychiatrist. I can see that strong demarcations exist but I do not understand the reasons why. Why do psychiatrists not treat victims of a stroke or a brain trauma and why do neurologists not deal with NPD or ODD? Maybe they do. If they are all brain abnormalities then why shouldn’t neurology just be absorbed into psychiatry? I do not understand the demarcation (which does not appear to be different in other cultures anyway).

Of course you don’t.
But, if you think I’m going to make a long post explaining this to you so that you can respond with a dismissive one line non-response, think again.
You prefer to remain ignorant anyway.

You are stuck in the rut of adaptive mutation and that is where you will stay.

By the way, I admit I do suffer from the brain abnormality known as NPD. Psychiatrists were going to remove this condition from the DSM5 – but me and my mates complained so strongly that they have now decided to leave it in.

Read the next two sentences in my last post to find out.
Here, I’ll make it EASY:

“The extended phenotype is not speculation. Beavers do build dams.
If that is all Chalmers and Clark were saying, they were not speculating.”

In other words, either they were talking about extended phenotypes and therefore were not speculating (beavers do build dams), or they were speculating and therefore talking about something else (if that is the case then perhaps yopu can enlighten us).

By the way, I admit I do suffer from the brain abnormality known as Koro or GRS. Luckily enough there is a little chinese shop around the corner where I can obtain medicine for this. Unfortunately I have not been diagnosed with adult ADHD, although my efforts are making good progress. I am actually trying to get some modafinil but amphetamines will do nicely thanks. Any advice?

‘In other words, either they were talking about extended phenotypes and therefore were not speculating (beavers do build dams), or they were speculating and therefore talking about something else (if that is the case then perhaps you can enlighten us).

I did make mention too of Richard Dawkin’s, and others, views of memes as extensions of the mind. The idea of genes exerting influence via the extended phenotype is similar/analogous but not quite the same. I am afraid I do not have enough space in the comments section of a blog post to give full justice to their ideas. You must do the hard work unfortunately.

By the way, I admit I do suffer from the brain abnormality known as Multiple Personality Disorder, or to give it the more sophisticated name – DID. I have five personalities or as some would say five totally different separate physical brains. But I can usually disguise this condition by a circumspect combing of what little hair I have left. Dr. Novella has given me good lessons.

Dirk, a neurologist that studies mental disorders can qualify as a psychiatrist in most jurisdictions. Except they are usually referred to as psychiatric neurologists or neuropsychiatrists. It can of course depend a lot on how they comb their hair.

‘he has his points and will not be dissuaded from them, even when they are eviscerated by sound arguments’

That is only because I suffer from Oppositional Defiant Disorder or using the more sophisticated terminology – ODD. As a neurologist, can you give me any advice on the cure? Drugs or scalpel? Insulin coma therapy or maybe ECT? I will let you, as the expert you are, decide. Thanks.

‘Dirk, a neurologist that studies mental disorders can qualify as a psychiatrist in most jurisdictions. Except they are usually referred to as psychiatric neurologists or neuropsychiatrists. It can of course depend a lot on how they comb their hair.’

Well I think beards are important too. Especially to those who consider themselves neuropsychologists. A little grey goatee can improve one’s reputation so much that one can confidently aspire to become neuralpsychopharmacologionist. Please excuse my dyslexia. You can double your salary and give lectures and get a bigger slice of the yearly $25 billion pharma marketing budget. I have tried to tell Dr. Novella of the benefits but he must have made, on the advice of Warren Buffett, a huge investment in Gillette. Never mind.

Dirk, neurology, psychology, and all the other associated fields require expertise to understand. The usual standard is 15,000 hours of study before a field can be understood. If you are not prepared to put that kind of time into trying to understand neurology, psychology, psychiatry or any of the other sundry mental health professions, you will never understand them.

What you are experiencing when you declare psychiatry to be a pseudoscience without understanding it is truthyness.

Those in the ‘modern western societies’ who understand the concept of ‘ubantu’ are now considered to be suffering from an abnormal brain disease. Which is one reason the US is happy to wage unlimited warfare to protect their ideological views. The rest of the world is not convinced.

I understand that our environment can condition our brain and produce neurological effects which can then change the physical development of the brain. So, not being ‘Xenophobic’ may be considered an abnormal neurological brain disorder? Like the Nazis even? Depends on our conditioning. The study of evolutionary psychology may reveal this process in action. I question whether our beliefs in our societie’s authoritarian insistance of the ‘denial’ of scientific truths , for example Drapetomania, is scientifically sound? Or I am an ‘unbeliever’ and a ‘heretic’. So it goes………

History suggests that the our need of ‘truth’ is not necessarily scientifically valid. The Inquisition for example. Sometimes we may need to stand outside of the prevailing myths in order to reveal the real ‘truth’. Thomas Kuhn suggested this.

But anyway.. I am just the normal bloke questioning prevailing views. So probably I am wrong. I just like to question stuff. I am most likely a denialist fuckwit and you are totally right. But now I have a whisky disorder and it is now time for me to shut up. In the UK I would be diagnosed with special brew insanity. Well I am.

Anyway I still do not understand the reason why a condition, an abnormal brain disorder, is sometimes treated by neurology and other times treated by psychiatry. Neurologists should be assimilated by psychiatry then? Why not?

Well, unlike those Australian beavers, they haven’t yet perfected the art of accelerating accidents. Psychiatrists are still more dependent on the Jungian concepts of mental magic while neurologists take a more slight of hand approach.

“If you think that the mind is the brain you may not be aware of cognitive science.”

More than familiar – that’s what I do for a living. You, however, are clearly not acquainted with the cognitive sciences, because there is literally not one shred of credible evidence that cognition exists outside of the brain – literally not one. There is no debate about this in the field.

…which you are misrepresenting. They are not proposing some sort of hocus pocus.

“For example David Chalmers and Andy Clark speculate that the mind can extend itself outside of the body. Read ‘Supersizing the Mind’ It is impossible for the brain to do that unless your mind is so open that your frontal cortex seeps out of your ears. (a little joke there…) What do you think?”

Dirk, actually I was referring to the beaver with a tail, not the tail with a beaver. In Australia however they have beaver tails that turned up on something now called a platypus, the unique features of which make it an important subject in the study of evolutionary biology. On the other hand, an excellent example to the home schooled locals of accelerating the accidents of nature to no purpose.

well, sadly, one of my own theories about a particular mental disorder has been shown to be true here, as I’ve seen it proven elsewhere so many times before. The executive function of the male genitalia will always overwhelm the other cognitive functions in the long run, regardless of the intellectual abilities of the individual. It’s impossible to localize this function, as it operates throughout the brain – being the largest part in fact.

When its display isn’t overtly sexual, it often manifests as aggressive argumentation, hardly disguised by the subject matter. I believe it’s related to the struggle for male dominance.

But, who am I to say it’s a disorder? Perhaps it’s a necessary part of our evolutionary functioning.

‘More than familiar – that’s what I do for a living. You, however, are clearly not acquainted with the cognitive sciences, because there is literally not one shred of credible evidence that cognition exists outside of the brain – literally not one. There is no debate about this in the field.’

Ok. I am just the average bloke sitting in the corner of the pub getting drunk philosophising rubbish. Any good books on cognitive science to recommend?

@BillyJoe7

‘The jokes are rather obvious and, in any case, lose any punch they might have had when you realise that they are there to cover-up the even more obvious ignorance on display.’

See above. A few years ago when I suffered from MDD after being dumped by the wifey, my neurological counsellor told me never to drink and dial. That was an age before the internet. Never booze and blog is the current ideology.

Anyway, after reading the DSM again, for a good laugh, it would seem I suffer from adult ADHD.

i.e often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
– often loses things necessary for tasks or activites at school or at home (e.g. Where is your homework? Sorry I ‘forgot’ it. 😉 )

Not to mention ‘Internet Addiction’ but I have been given the appropriate drugs to cure this one.

I’d completely forgotten that I’d already answered this one in another thread:

Here is why “adaptive mutation” will never displace “random mutation and natural selection”:

It is not possible for “adaptive mutation” to get off the ground on its own.
In other words, it takes “random mutation and natural selection” to set the scene for “adaptive mutation”.
And “adaptive mutation” is itself an accelerated form of “random mutation and natural selection”.

That’s about it.

As a specific example, when the immune system is challenged, it produces numerous slightly different immunoglobulins. This capacity has been built into the organism as a result of “random mutation and natural selection”. And the production of these numerous slightly different immunoglobulins is the result of what can be described as accelerated “random mutation”. The immunoglobins that most effectively fight off the invading organism, feed back to increase their own production at the expense of the immunoglobulins that are ineffective. This is just accelerated “natural selection”.

Certainly, nowhere in this process of “adaptive mutation” is there any directedness or striving towards or inheritance of acquired characteristics (see next paragraph).

It is true that there can be changes to DNA as a result of “adaptive mutation” (such as methylation) that is passed onto the next generation, but this is lost after only a few generations and therefore cannot be the cause of evolutionary change.
And, again, this capacity for “adaptive mutation” was provided in the first place by “random mutation and natural selection”.

It will again not receive a meaningful response from our court jester.

“@steve12
‘For one thing, Chalmers and Clark aren’t cognitive scientists’
Sorry for that mistake. I thought that Clark was director of the Cognitive Science Program at Indiana University in Bloomington.”

You are the dogdey-est of the dodgey. Set aside the whole post on what you think is some sort of technical victory – but sadly, no.

That Clark held that position (he did – he’s somewhere in Europe now) does not make him a scientist, anymore than his and Chalmer’s idea posits some hocus pocus cognition outside the mind as you state, anymore than the idea they actually posited has any evidence for it (though I find it interesting).

Would you concede that say something like prolonged exposure improves “an apparent mental illness” that is causing someone to suffer?

I guess what I am asking is that, ok, you do not believe this is a “disease” in the scientific sense – but you do acknowledge that these people suffer…from what I am unclear of…but will you acknowledge that psychiatry/psychology is a means to mitigate this suffering in many examples?

In my mom’s example, she was bascially nuts by any lay person’s evaluation…hallucinating…etc…and then with treatment she was not and she could work and function….what happened to her? And what other track would you have had my mother follow Dirk if you were in control of her life? If you would not recommend a psych hospitalization and psychiatric care, then what would she receive? honestly?

I am not looking for victory although I do argue hard from one side of the fence in order to provoke responses that I can then think about. I am trying to learn here cos I know I can be stupid.

So my first question is. What is the mind? Defined scientifically.

My second question is what is a disease/illness?

I then try to understand what is meant by ‘mental illness’. To understand what psychiatry actually does and how it treats. And to understand it in relation to neuroscience – which is, I think, a proper science. One person that has convinced me to alter my previous perspectives happens to be Thomas Szasz. When I see tons of criticism to his position I try to respond – which is why I am here. Of course I do not have his intellect so I probably do not give proper justice to his views.

‘Because they treat different things? Why are you so interested in this arbitrary distinction? If you want more information just look up the different pathologies they treat for…’

I suppose I am trying and failing to ask a deeper question here. If, as some people on here are trying to tell me, the mind is the brain, then why do we have psychiatry? I am asking, that if ADHD as Steven says, is a brain disease, then why is it not treated by neurology? Why is one brain disease treated by a neuroscientist and another by psychiatry? You may call this an arbitary distinction but I do not think it is. If say it is found that there is a biological lesion that is the cause of schizophrenia, then, like neurosyphilis, it will cease to be treated by psychiatry and would be treated by another medical discipline. If all mental illness is shown to have a biological basis then psychiatry would cease to be!

‘but you do acknowledge that these people suffer…from what I am unclear of…but will you acknowledge that psychiatry/psychology is a means to mitigate this suffering in many examples?

In my mom’s example, she was bascially nuts by any lay person’s evaluation…’

Of course I know that people suffer. I have my own experiences. What I am trying to do by questioning psychiatry is actually an attempt to resolve these situations to do good. But it is only by understanding the true nature of these things that we can progress to the next step. I happen to think, that the idea that if psychiatry states that depression and psychosis is the result of a chemical genetic brain disorder then they must provide the scientific evidence for this. Their claims over the past 100 years simply have not been met. There has been no progress. No defined pathology, no cures. Even the medicine does not work and in many cases makes things far worse.

So I see psychiatry with a skeptical view in the same way I think homeopathy and crystal healing are scientific bullshit. To call people nuts and that they have a ‘mental’ disorder is actually stigmatising and disparaging that person and their suffering.

It is well known that experiencing extreme stresses in life can cause terrible harm. I do not like the approach of psychiatry. I would prefer to ask not ‘what is wrong with you’ but ‘what has happened to you’ Not to give the sedation but to understand the person fully as a unique individual. If that makes sense.

Anyone who would like to understand Szasz more could do worse than start here. There are arguments in this podcast for and against him. He does a much better job than I ever can of explaining his views. 😉

‘If you were arguing in good faith, Dirk, I would believe you. But you are arguing for victory with a pre-ordained goal.’

My only goal has only to counter those such as Steven Novella who call Szasz a crank. Who actually misrepresent his ideas. I believe in the scientific method as the only way for us to make progress. I actually support all of Steven’s other views about science such creationism and evolution and homeopathy et al. But I remain skeptical about psychiatry. I think it, unlike neuroscience, fulfils much of the criteria of a pseudoscience. I may be wrong. I have been before! But I will try to engage in the debate first. With too much vigour sometimes, and not a little tongue in cheek.

I’m not talking about your world-view or any of that. I’m talking about your specific responses to my (et al.) questions, which willfully did not address points posed to you which would weaken your argument

“I’m not talking about your world-view or any of that. I’m talking about your specific responses to my (et al.) questions, which willfully did not address points posed to you which would weaken your argument”

Sorry for that. I got into a muddle at one point cos there were probably too many people responding to me than my mind could manage. I will look back on the thread but if you have time maybe you could point me those… Thanks.

Wow this guy has a lot of time on his hands and a burning need to be the last word. Dirk Steele. Well here is some more attention for the troll. I think that you do not exist and you are a fabrication of Dr. Novella to demonstrate the ridiculousness of the position. Or you are selling something. Either way answer or don’t, this is the last recognition you will receive from me.

And then I got BillyJoe7 to repeat his “scientific” explanation of adaptive mutation as being accidental on purpose.
“And the production of these numerous slightly different immunoglobulins is the result of what can be described as accelerated “random mutation”.
No, nothing can meaningfully be described as “accelerated” randomness without explaining how the organism could accelerate randomness. It’s the most obvious oxymoronic contradiction in terms ever.
Because if an organism did such a thing at all, then the acceleration would be done for a reason. Not some reason from the sky unconnected to the organism’s experience.
And further, the on the spot production of different immunoglobulins is not the adaptation process to begin with. Adaptation involves the evolution of the function which will produce these immunoglobulins in direct response to the nature of the organism’s particular problem. There is, again, a direct connection there between the experience of the organism and its answer to the problem it has experienced.
Further, the adaptive mutation theory IS an auxiliary theory of the main Darwinian theory of natural selection. What is being touted here by BillyJoe7 is the corrupted version introduced by such as Dawkins, which BJ7 has garbled in turn to suit the deficiencies of his understanding.
Dawkins quote: “There are causal arrows leading from genes to body. But there is no
causal arrow leading from body to genes.” Nutty enough right there without inventing accelerated randomness to boot.

@Dirk
“To call people nuts and that they have a ‘mental’ disorder is actually stigmatising and disparaging that person and their suffering.”
A diagnosis of a specific mental disorder is merely a descriptor, a term that identifies them as having a disabling mental condition with certain specific characteristics. It’s society’s approach to people with mental disorders that causes the stigmatization.

“It is well known that experiencing extreme stresses in life can cause terrible harm. I do not like the approach of psychiatry. I would prefer to ask not ‘what is wrong with you’ but ‘what has happened to you’ Not to give the sedation but to understand the person fully as a unique individual. If that makes sense.”
Why do “what is wrong with you” and “what has happened to you” have to be mutually exclusive questions? I mean, if someone came in to the hospital with a broken bone, then a good doctor would try and figure out both things – what kind of fracture it was, but also why the fracture had happened.

‘It’s society’s approach to people with mental disorders that causes the stigmatization.’

I agree. But I also include the psychiatrists as a powerful part of society.

‘then a good doctor would try and figure out both things –what kind of fracture it was, but also WHY the fracture had happened.’

When I broke my ankle playing football, the doctor had no interest at all in my story about the thug and the vicious, and if I may say so, illegal tackle that caused it. Nor was he interested in the fact that the referee was so pathetic that he lost control of the game and did not even send off the offending bastard. Much to my annoyance at the time, he did not listen to my wonderful story and all he did was to focus his attention totally on the x-rays. I was very happy with my treatment however and eventually resumed my rightful position as the slowest centre back in the whole league! 😉 But I agree with your general drift…..these questions are not mutually exclusive.

“Of course I know that people suffer. I have my own experiences. What I am trying to do by questioning psychiatry is actually an attempt to resolve these situations to do good. But it is only by understanding the true nature of these things that we can progress to the next step.”

I am still not at all clear what exact advice you would give to a son when his mother is raving in public at the top of her voice, screaming, crying, and asking her children to dig up bodies in the yard? As far as I can tell based on your responses, you believe that there simply is nothing else to do with her except study her to try and “understand the true nature of these things” in hopes of a “true diagnosis”…is that safe to say? I mean if psychiatry will only offer her the equivalent of homeopathy I suppose it would make more sense to get her to another provider to study her disease in a proper manner…in which case, would you mind giving me a referral to someone for my mother? She may need to come off all of these meds that are simply mind numbing psuedoscience and seek proper scientific based medicine…please provide a name and describe what exactly they will subject my mother to in order to better understand her suffering?

Also, how I wonder would homeopathy fair up to in efficacy in alleviating these symptoms as compared to “usual psychiatric care”? Is that a valid question to ask?

“question of why neurology is not just subsumed into psychiatry so that we only have one medical discipline that deals with abnormal brain disorders has not really been answered.”

Physiphile already sort of answered this, but I will take it a bit further. Medicine has become very subspecialized. There are actually a few training programs where residents receive combined training in Neurology and Psychiatry, but they are few and far between. The reason – too much material to cover in depth to do all the topics justice. Within neurology there are multiple subspecialties, many of which require fellowship training beyond the standard training. Psychiatry is the same. Most clinicians have more than enough patients to stay busy even within very subspecialized disciplines.

Think of it this way – do you want a cardiovascular surgeon doing your liver transplant? No – you want a transplant surgeon. Neurologists and psychiatrists both treat disorders of the brain. They simply focus on different conditions under that broad category.

Here is cwfong playing around with words and phrases because he can’t respond in any meaningful way.

cwfong: “accidental on purpose”

Nope. Random mutation and non-random natural selection.

cwfong: “nothing can meaningfully be described as “accelerated” randomness”

I travelled at 30 kph. Now I’m travelling at 100 kph. I have accelerated.
Through evolutionary history, random mutation has been a slow process. Within the organism it is a fast process. The process has accelerated.
That is all I mean. But you know that. You are just avoiding a meaningful response. As always.

cwfong: “if an organism did such a thing at all, then the acceleration would be done for a reason.”

No reason.
The organisms that [slowly] evolved an immune system with the ability to [quickly] produce a large number of randomly mutated immunoglobulins improved their chances of survival. Because, by doing so, that had a greater chance of producing the specific antibody that destroyed the particular bacteria or virus they were being invaded by.

cwfong: “Adaptation involves the evolution of the function which will produce these immunoglobulins”

Nope. Random mutation and non-random natural selection through [slow] evolutionary time produced these immune systems that produces these immunoglobulins.
Adaptive mutation can not get off the ground without it.

cwfong: “adaptive mutation theory IS an auxiliary theory of the main Darwinian theory of natural selection.”

Now I could have sworn that you are about to overthrow Darwinian evolution.
Well, okay, if you have abandoned Shapiro, nevermind then.

@BillyJoe7,
“Through evolutionary history, random mutation has been a slow process. Within the organism it is a fast process. The process has accelerated.”

Does he realize that statement makes no sense at all. We’re talking about a process that has either always been within the organism or not. He’s now arguing that evolution was for a long time a process without the organism and more recently it has moved inside and, although still random, has managed to speed itself up.
Christ evolving crickets on a crutch makes better sense.

Thinking that Shapiro and the like are not followers of Darwin’s designated evolutionary path tells us the thinker couldn’t find his path with both sandals.

“For 50 years, the world believed that mutations occur at random. The discovery of “adaptive mutation” in bacteria shook the foundation of that dogma, implying the existence of a another kind of mutation that differs from normal spontaneous mutations. The “adaptive” mutations occur when they are selected, in cells that appear not to be dividing, and had been found only in genes whose functions were selected. We are elucidating the molecular mechanism by which these mutations form. We have found that genetic recombination enzymes are required for some adaptive mutations. We are uncovering a new and unexpected molecular mechanism for mutation in nondividing cells that includes DNA double-strand breaks, recombination, DNA synthesis, and suspension of postsynthesis mismatch repair, and which occurs in a hypermutable subpopulation of the cells. The mutations are similar to those characteristic of some cancer cells. This new mutation mechanism in nondividing cells may be an important model for mutations that give rise to some types of cancer and genetic diseases, cause resistance to chemotherapeutic and antibiotic drugs, lead to pathogenicity of microbes, and participate in many other systems previously thought to follow the rules of classical growth-dependent mutation.”

Dirk, you have the apparent delusion that there is something called a “mind”, which is immaterial but lives mostly in the brain, but can have an existence separate from the brain, and that when psychiatrists do talk therapy, they are only affecting this “mind”, and are having no effects on the brain.

This is nonsense and no competent psychiatrist thinks this.

There is no “mind”, there is only the brain. Everything that humans do that requires neural input comes from the brain. When memories are formed, they only form because the physical structure of the brain has changed. If the physical structure of the brain did not change, then memories could not form.

Talking to someone does have effects on their brain. Humans are social animals, when humans talk to each other, their brains self-modify so as to remember the interactions. Their brains also “tune themselves” to interact better/differently the next time. It is called “getting to know someone”.

We know that every interaction that can be remembered changes the physical structure of the brain.

People have found that some dysfunctional brain states can be helped by talking with a psychotherapist. There is nothing shocking or surprising about that.

“When memories are formed, they only form because the physical structure of the brain has changed.”

And here I thought that the mind was the function of the brain that gathered the information that then caused the physical structure of the brain to change as a consequence of its functional need to retain what the mind had also decided was relevant.

“If say it is found that there is a biological lesion that is the cause of schizophrenia, then, like neurosyphilis, it will cease to be treated by psychiatry and would be treated by another medical discipline. If all mental illness is shown to have a biological basis then psychiatry would cease to be!
So I am trying to understand these kinds of issues…”

I hear you on that last part. Even practicing neurologist and neuroscientists sometimes get tripped up with the distinction between physiology and how it describes cognition. Let me try and clarify:

There is a huge difference between knowing a lesion causes a defect in cognition and understanding how the brain creates that cognitive function. In fact, I don’t believe that in my lifetime we will understand physiological basis of the emergence of the cognitive function. Neurologist are more interested in the low level physiology and how it modulates behavior where as psychiatrist look more at emerged product and infer physiology based on this and manipulate physiology (eg drugs, electroshock, etc) to achieve a desired cognition. So they are approaching the problem from different perspectives but there is no one perspective that’s better. If they merge, as you suggest, then I wouldn’t say neurology consumed psychiatry or psychiatry consumed neurology but that the breadth of knowledge about cognition has less gaps – but this isn’t going to happen in our lifetimes.

“If say it is found that there is a biological lesion that is the cause of schizophrenia, then, like neurosyphilis, it will cease to be treated by psychiatry and would be treated by another medical discipline. If all mental illness is shown to have a biological basis then psychiatry would cease to be!”

There are flaws in every step of this progression of ideas. Schizoprenia is not a new disease and has been extensively studied, so finding that it is cause by a lesion is really unrealistic, but that aside- a new finding about the potential cause of a disease will not necessarily change how it is treated, particularly in the short term. To say that psychaitry will no longer treat the disease if schizophrenia is found to have a biological basis requires a very simplistic understanding of both the disease and the practice of medicine. Besides, no ‘if’ is needed in your statement… of course there is biological basis (human physiology is a subset of biology), it is just a complex one

There are many areas of medicine in which the precise causes of conditions are not known, yet successful treatments are available. For a simple example look at primary hypertension – by definition the causes are not identified, yet there are many treatments available for the treatment of the condition, and treating it can reduce the risk of cardiovascular events, among other things. Now the initial recommendation for the treatment of hypertension for most people is a thiazide-type diuretic (with allowances for most other classes given other comorbidities), but this is without regard to the cause of the disease (because primary HTN has no identified cause).

Therefore, the basis for such a recommendation is not based upon a determination that the disease is cause by a lack of urination, but it is primarily based upon evidence that giving a thiazide-type diuretic reduces blood pressure and, more importantly, it reduces cardiovascular events.

In your example, schizophrenia is complex and we are not going to find a single or simple cause, so the best treatments will be determined by how they are effective and treating the positive signs/symptoms (e.g. hallucinations, delusions, disorganized behavior, etc) and the negative signs/symptoms (e.g. flat affect). Given the complexity of mental conditions, this is the best we are going to be able to do in the near future. I realize that some people are not comfortable with nuance, but being a black and white thinker makes a person practically blind in this world of not only grays, but many colors

‘where as psychiatrist look more at emerged product and infer physiology based on this and manipulate physiology (eg drugs, electroshock, etc) to achieve a desired cognition.’

Exactly. Psychiatrists look at unwanted behaviour, ‘infer’ physiology, because there is no scientific evidence and use brain damaging drugs and procedures to achieve this ‘desired cognition’. All the desired behaviours are defined in the DSM5 and are mostly proscribed and authoritarian. So the deviants in society, such as the unruly child who hates school and does not respect the authority of the teachers etc etc, are deemed to have a ‘mind disease’ and forced to take drugs to make them ‘ model students or citizens. It is a racket with no scientific basis.

‘Therefore, the basis for such a recommendation is not based upon a determination that the disease is cause by a lack of urination, but it is primarily based upon evidence that giving a thiazide-type diuretic reduces blood pressure and, more importantly, it reduces cardiovascular events.’

Yes this is medical science. I do understand that, like diabetes, there may be no known cause. But there are objective measurements made.

‘In your example, schizophrenia is complex and we are not going to find a single or simple cause, so the best treatments will be determined by how they are effective and treating the positive signs/symptoms’

You are making an unscientific assumption here that schizophrenia is a disease. Not to mention that the outcomes for schizophrenia are worse now than ever before (see Robert Whitaker). The symptoms are unwanted behaviours. There is no objective test. Maybe if you get a little time you might listen to what Thomas Szasz has to say http://www.youtube.com/watch?v=JAbEzu7zAW0 and then respond. Difficult to do justice to this as a comment in a blog.

‘I am still not at all clear what exact advice you would give to a son when his mother is raving in public at the top of her voice, screaming, crying, and asking her children to dig up bodies in the yard?’

This is a moral problem here not a scientific medical issue. What does society do with the unwanted – the hopeless or helpless, the addicts and the homeless or even those that are deviants and who behave in ways that society does not want. I have given you links to those who suggest different paths to biological psychiatry. If you want to know more you must do your own research cos I cannot explain this in enough detail in a blog comment.

Here I show that cwfong either does not know or does not understand his own hero’s arguments

cwfong: “We’re talking about a process that has either always been within the organism or not. He’s now arguing that evolution was for a long time a process without the organism and more recently it has moved inside and, although still random, has managed to speed itself up.”

Or maybe you have ignorantly failed to understand what I have written.
Hint: I gave you the short version, which necessarily requires some interpretation on the part of an intelligent reader.
But here’s the dummy version just for you:

Random mutation and natural selection through millions of years of evolutionary change produces an immune system to fight off invaders.
This process is SLOW.
It also does not occur within an organism but through a long line of organisms through millions of years of evolutionary time.
Okay?

The immune system that evolved as a result of the above mechanism functions as follows. When the organism is invaded, the immune system produces numerous mutations in the genes that code for antibodies, and they do this RAPIDLY. And this happens within the organism.
RAPID MUTATION within the organism.
Get it?

(And, remember, this capacity was built into the organism by the long SLOW process of random mutation and natural selection through a long line of organisms through millions of years of evolutionary time.)

As a result, numerous slightly different antibodies are manufactured. Those that bind the invaders antigen sites feed back to increase the production of these antibodies at the expense of the antibodies that do not provide a good fit. Thus the antibodies that fit are SELECTED for, and this happens RAPIDLY.
RAPID NATURAL SELECTION within the organism.
Get it now?

But don’t take my word for it.
Here is you own hero Shapiro saying the exact same thing:

Is there not a more relevant thread than you can use to discuss this. I get called a troll because I left comments on a discussion of homeopathy to suggest that psychiatry is also seen by some to be pseudoscientific. You guys are far bigger trolls than I am. Though I did get a good response tho! 😉

cwfong: “Thinking that Shapiro and the like are not followers of Darwin’s designated evolutionary path tells us the thinker couldn’t find his path with both sandals.”

From the horse’s mouth:

Here Shapiro is effectively denies modern evolutionary theory/neo-Darwinism:
(Most of his examples are not evidence against neo-Darwinism at all, but I will not attempt to explain why in this post, because that is not the intent of this post)

“There has always been controversy about whether random variation and natural selection for improved fitness can truly explain biological evolution over time.”

“When we wish to create new plant species artificially, we do not use selection. We generate hybrids by mating different species.”

“Doubling the genome takes one generation and potentially affects all hereditary traits. Note that the production of new species with novel characters by hybridization occurs too rapidly for natural selection to act creatively.”

“Perhaps the most important evolutionary step of all took place at least one billion years ago, when two or more cells fused to produce the first “eukaryotic” cell having a defined nucleus”

“It’s remarkable that even though processes like hybridization and symbiogenesis have been well-known for decades, many neo-Darwinists firmly insist on gradualism in evolutionary change”

“Microbes transform into superbugs in a few minutes by “horizontal DNA transfer.”

“The answer may well be that it was a basic mistake to think that optimizing fitness [natural selection] is the source of biological diversity.”

“The first problem with selection as the source of diversity is that selection by humans, the subject of Darwin’s opening chapter, modifies existing traits but does not produce new traits or new species. Dogs may vary widely as a result of selective breeding, but they always remain dogs.”

“Do you mean to say there can be no scientific alternatives to Darwin’s theory of evolution? If you…look at the history of evolutionary thinking, you will see there have always been alternatives. Molecular biology and genome sequences allow us to specify alternatives with greater precision”

“I would argue that an evolutionary theory based on modern observations is a better answer to Creationism than an outdated theory, especially one which utilizes the creative powers of natural selection as a Deus ex Machina to resolve all difficulties. “

“So the deviants in society, such as the unruly child who hates school and does not respect the authority of the teachers etc etc, are deemed to have a ‘mind disease’ and forced to take drugs to make them ‘ model students or citizens.”

Would you rather deviants stay deviants? I wouldn’t. So, you can live your life keeping your kids away chemicals that change cognition to a desired state (although you’ll be doing this through environmental exposures), and when I have kids and if they have ADHD I will treat to shift their cognition to one that has a greater attention span and better outcomes.

This is the world we live in and there is no way for you to change it and we are only at the beginning of mind manipulation. We have figured out how to endogenously manipulate the chemical environment of our brains to control cognitive effects. This is a power tool and people are going to use it as they see fit.

‘Would you rather deviants stay deviants? I wouldn’t. So, you can live your life keeping your kids away chemicals that change cognition to a desired state (although you’ll be doing this through environmental exposures), and when I have kids and if they have ADHD I will treat to shift their cognition to one that has a greater attention span and better outcomes.’

This is a very dangerous statement. Draptomania was considered a mental disease. Homosexuals up until the 1980s were considered to have a mental illness. Psychiatry has and is still being used to suppress dissident views either political or religious. One of my sons was diagnosed as ‘ADHD’ but in my opinion had a different artistic and creative drive to my other sons and did badly at school because he did not conform to what the school ‘authorities’ needed. There is no evidence, that the drugging of children results in better outcomes. None. There is evidence of brain damage caused by these drugs. (which is why there are schedule II and illegal for me to use)
So you want to drug your child by force to get him to conform to your wishes of what he will be? I consider this to be immoral. Your view is based on a ‘religious’ belief. Nothing to do with science.

“One of my sons was diagnosed as ‘ADHD’ but in my opinion had a different artistic and creative drive to my other sons and did badly at school because he did not conform to what the school ‘authorities’ needed.”

I have sympathy for this aspect of your complaint. Medications are not the only way to help people who struggle in this regard, but that is often the easiest route and is perhaps this route is taken too often (maybe in some cases, maybe not in others). There are other approaches to teaching that may be more helpful for people who learn differently, but that may require taking him out of the environment in which he is struggling, and to put him in another one which meets his needs. I also agree that the same person who struggles in a traditional school environment may have some advantages in other environments. I can’t speak to your specific example, but I don’t think anyone here is saying medication is the only method for helping people.

That does not mean, however, that there is no role for medications at all. You are reacting as a parent and you are not objective in this assessment when you dismiss the field of psychiatry. You are responding as an advocate to an extreme degree that you become a denier. You complain that there are no “objective” measures, but you are failing to acknowledge the nature of what is being studied. Thinking and behavior are complex things, and we are not going to find a simple and universal way to assess them. That does not mean that any and all assessments are useless

“This is a moral problem here not a scientific medical issue. What does society do with the unwanted – the hopeless or helpless”

Indeed, it would seem that you and the critics you speak of would not be in denial that there are those like my mother that suffer, but I simply think that you are in what appears to be avoidance or denail of the basic experience and outcomes of those that recieved such psychiatric care.

What does society do with the “unwanted” and “hopeless”?…in my mom’s case, she recieved psychiatric/psychological care both in patient and out patient and had done much better with this treatment – this was my perception as a 11 year old, that mom was then “normal”…she smiled, brought me to school, and was not actively thinking about dead babies barried and asking folks to dig them up and screaming at the top of her lungs, and she worked, and just felt better herself….

I think to deny her the care that she recieved and the outcomes that are so apparent both in my experience and within the body of literature for such patients, would be immoral…and indeed perhaps in total denial of what facts we have so far….no doubt new facts will arise one day and treatements will be improved though….maybe even some scientists of your ilk will identify some things that will be helpful in ways? But denial of benefits of psychiatry/psychology at this point I still take issue with based on my personal experience anyway, as well as my knowledge of literature on the matter (I know, there are studies for homeopathy as well, I find this equilancy absurd honestly).

‘You are responding as an advocate to an extreme degree that you become a denier.’

My son is a chef now doing fine. He did not take stimulants. It was obvious to me that his difficulties at school were to do with the fact that, because school intakes are based on birthdays, he had to start school one week after his fourth birthday whereas my other sons started when they were nearly one year older. So he found it difficult to cope. He lost interest and started to pursue other activites, art, photography and sculpture. The school were not interested because these subjects did not improve their statistics required by the govt. I also am of the belief that children do not develop at the same rate but this fact also is ignored. When I was at school in the 60s ADHD did not exist. But the nature of school was very different. I also know that children schooled in the home have far lower levels of ADHD diagnosis. Anyway this is anecdotal but I have researched this further.

The problem I have with ADHD studies are to do with correlation and causation. I think that saying that genes or brain ‘disease’ will result in ADHD (not scientifically proven yet tho) is pure speculation. Or are changes in the brain the result of bad experiences in childhood? There is more scientific evidence for this. There is also evidence that stimulant treatment causes damaging effects. Smaller growth and also smaller brain growth. Not to mention psychosis which then is treated by neuroleptics and other chemicals to treat the tics and dyskenesia. Not to mention the SSRIs for the resultant depression from being diagnosed (stigmatised) with a brain disease.

If by arguing against you and Dr Novella makes me a ‘denialist’ and equivalent to a creationist well …I will live with that.

‘Indeed, it would seem that you and the critics you speak of would not be in denial that there are those like my mother that suffer, but I simply think that you are in what appears to be avoidance or denail of the basic experience and outcomes of those that recieved such psychiatric care.’

Then you totally totally misunderstand the argument. As Dr Novella misrepresents it. I have given you links so that you can understand more. I cannot explain them full within comments. Why not have a look or read?

“started to pursue other activites, art, photography and sculpture. The school were not interested because these subjects”

I don’t believe your school did not have electives in art, photography and/or sculpture. Are you telling me your son did not take art, photography or sculpture in grade school? I’ve been to several different schools in my life and all of them offered various art courses including theater and pottery which I took as many as I could.

If your child was not progressing then you could have simply held him back until he was able to meet the criteria for entering the next grade level. And most jr high schools these days allow you to go at your own pace by choosing electives that fit skill level. eg art I, II, III…

I will gladly later look through and read the links that you provided, but I find it more interesting at least for now, that you will not respond to the basic premise that indeed, my mother got significant improvement with psychiatric care…and your response to that is basically that rather she was hopeless…

Perhaps I have misrepresented your stance, or perhaps you are indeed just dodgy…ill read some more as you suggested….

“If by arguing against you and Dr Novella makes me a ‘denialist’ and equivalent to a creationist well …I will live with that.”

Its not the argument itself but the lack of progress when evidence is presented. I do not doubt your account of your son, and I am not saying that your son needed medication. Quite the contrary- if it were my child, medication would not be the first on my list of interventions. The problem is that you are ideologically committed and impervious to evidence and argument (that is denialism). I said a lot of other things in my last comment, which you avoided presumably because you have no good answers for them. Without progress in the conversation, I lose interest. I am only here to increase understanding, not to read and write the same ideas over and over again

I see Dirk is upset because he thinks this is his thread and thus I shouldn’t answer BillyJoe7, etc., etc., etc. Dirk, you know what you can kiss if you could find it.

BillyJoe7 couldn’t dispute the quote from Susan Rosenberg so he turned to an article from Shapiro. Who was arguing against neo-Darwinism, and BillyJoe7 thought that was thus against all of Darwinism.

Shapiro clearly states that there are alternatives to Darwin’s explanations, since he had no access to the tools of modern biologists. But the alternatives mentioned by Shapiro are auxiliary theories, not refutations of Darwin’s work at all.

So even though he thinks Shapiro is anti-Darwin, BillyJoe7 still finds Shapiro is on his side of his befuddling exposition of accelerated randomness, which to quote again was:
“Evolution is adequately explained without the need for purpose. Even adaptive mutation is a form of (accelerated) random mutation and non-random natural selection.”

Yet the very article BillyJoe7 relies on, “Purposeful, Targeted Genetic Engineering in Immune System Evolution,” actually says the opposite:
“Your life depends on purposeful, targeted changes to cellular DNA. Although conventional thinking says directed DNA changes are impossible, the truth is that you could not survive without them. Your immune system needs to engineer certain DNA sequences in just the right way to function properly.”

So while purpose does seem needed there, accelerated randomness surely doesn’t. It’s purely the invention of an addled mind.
Shapiro says: “The immune system is itself a rapid evolutionary process, replacing one set of immune specificities with another.” Nothing in the article at all about accelerated randomness at all.

In fact the only time it’s mentioned is when he concludes as follows:
“In biology, the alternative to randomness is not necessarily strict determinism. If the cells of the immune system can use well-defined natural genetic engineering processes to make change when change is needed, there is a scientific basis for saying that germ-line cells might do the same in the course of evolution.”

This is the exact opposite conclusion from the one BillyJoe7 came to after reading into it only what he wanted and therefor needed to see there. At this point, even concrete thinking can’t explain his problem.

‘The problem is that you are ideologically committed and impervious to evidence and argument (that is denialism).’

I am ideologically commited to using the scientific method to understand reality. My stance depends on the scientific evidence. For example where is the ground breaking paper which demonstrates the actual cause of ADHD? Of course Dr Novella would say there are very many causes, genetic, biological, brain chemicals, frontal lobe or amygdala size and with just a bit more reseach bla bla bla. This is nonsense. I will look back at your comments to see those points you think I have avoided and try to respond.

‘I will gladly later look through and read the links that you provided, but I find it more interesting at least for now, that you will not respond to the basic premise that indeed, my mother got significant improvement with psychiatric care…and your response to that is basically that rather she was hopeless…’

Szasz is not ‘anti-psychiatry’ and nor am I. I am happy your mother improved with treatment. What exactly was that treatment? Where have I said she was hopeless? You misunderstand. I do not know her history or her treatment or nothing about her. So I cannot respond here. What I am saying is there is no scientific evidence to show that psychosis or whatever is a mental illness as opposed to her problems being caused by environment. Is a brain disease the real ’cause’? Or are the symptoms the result of ‘stress’ in one’s life?

‘I don’t believe your school did not have electives in art, photography and/or sculpture.’

Are you telling me now you are an expert in the UK education system of the 1980s/90s? My son could not take both art and photography because the timetables clashed. He was encouraged to take business studies instead! You have obviously never bothered to look at my suggestion to watch Sir Ken Robinson on the video link I provided or on tedtalks. Are you familiar with John Gatto? How old are you?

Yeh well you must be a creationist then. In over one hundred years of studying schizophrenia for example there has not been one jot of scientific evidence to show that is caused by a mental disease/illness. There has therefore been so much evidence against.

“did badly at school because he did not conform to what the school ‘authorities’ needed.”

‘What did they need?’

Their needs were totally different to my son’s needs. They wanted to only ‘model student’ clones.
Differences in thoughts and actions were forbidden. They want compliance and conformity. Modern schools are prisons. I am old so I can see how the institution has changed for the worse.

‘a new finding about the potential cause of a disease will not necessarily change how it is treated, particularly in the short term. To say that psychaitry will no longer treat the disease if schizophrenia is found to have a biological basis requires a very simplistic understanding of both the disease and the practice of medicine.’

Are you joking here? In scientific medicine the only time lag is in finding the successful treatment. Are you talking about infectious disease caused by bacteria? Diabetes? Cancer? Cardiovascular disease? Broken bones? We may not know the ultimate cause but we know what it is by an objective scientific measurement. If I went to my medical doctor suffering from chest pains he would not just give me a ton of morphine and say come back in a month and see if that makes you feel you feel better! This is the level of science in psychiatry. No progress in over 100 years. Nothing. The first sign of a pseudoscience.

I hope this is one of the issues you thought I had deliberately ignored. Any others?

My point is that if a treatment works for a given condition, it doesn’t cease to work when there is further understanding about the condition it treats. The thiazide diuretic example was intended to show that a medication can be used without establishing a single cause of a condition. The only time the recommended treatment will change is if there are other treatments that have shown to be superior in some way. Perhaps that would come from the further understanding of the condition, but it doesn’t invalidate the treatments that were shown to be effective prior to this greater understanding. Bottom line is that your argument that our lack of understanding of conditions invalidates the treatments currently used is just wrong

“Dr Novella would say there are very many causes, genetic, biological, brain chemicals, frontal lobe or amygdala size and with just a bit more reseach bla bla bla. This is nonsense”

So your arguments are …”bla bla bla. This is nonsense.” Did you then stick your fingers in your ears and say ‘La la la la la?’ This shows me that you have enough understanding but don’t want to hear it. You are having a problem with black and white thinking on this topic and can’t let go.

**We will never find a single cause for mental illness. You set that bar because you know it is unrealistic, just like a Creationist wants to see a chimp give birth to a human before believing in evolution (even though that is not what evolution would predict). Perhaps you think we should find such a single cause for mental illness or it is not real, but you are simply WRONG. You have a problem acknowledging complexity

‘Perhaps you think we should find such a single cause for mental illness or it is not real, but you are simply WRONG. ‘

The very concept of a mental illness, a disease of the mind, is scientific nonsense. It is a misuse of language. A metaphorical statement made literal. Only diseases of the brain exist. But a scientific objective measurement is necessary to prove this. A medical diagnosis is required. All else is just woo.

If psychiatry is the equivalent of homeopathy, then will homeopathy reduce psychosis with the same efficacy as antipsychotics? Will accupuncture mitigate hallucinations the same as antipsychotics? Will Reiki reduce mania the same as depakote?

Is there evidence that antipsychotics reduce the symptom of psychosis and hallucinations? Are you really stating that psychopharmacology has no proven mitigating effect on such symptoms? Because homeopathy has no appreciable effect except that of a placebo, which is to say essentially it does absolutely nothing.

Dirk – it is frustrating arguing with you because there is so little progress. The examples you mention in your last comment conflate treatments or conditions with no evidence/justification but cause much harm with those with some evidence/justification and cause little harm and everything in between. You have demostrated nothing with those comments, and you appear to be uninterested in progressing.

Hopefully some of the comments here were helpful and not all antagonistic, but I’m just gonna move on at this point.

‘Is there evidence that antipsychotics reduce the symptom of psychosis and hallucinations? Are you really stating that psychopharmacology has no proven mitigating effect on such symptoms? Because homeopathy has no appreciable effect except that of a placebo, which is to say essentially it does absolutely nothing.’

They reduce the symptoms of psychosis in the same way that morphine does. They are brain disabling. Sometimes this can be useful to resolve a short term crisis. There is no evidence to suggest they ‘resolve’ anything, unlike insulin for diabetes. The is however well documented scientific evidence to show they cause brain damage such as this http://www.youtube.com/watch?v=W_3bbpFjI68

‘The examples you mention in your last comment conflate treatments or conditions with no evidence/justification but cause much harm with those with some evidence/justification and cause little harm and everything in between.’

I can quite accept that I do not have the intellect to speak on behalf of Szasz. Anyone interested can hear from the man himself here. The three part radio show will probably take less time than commenting further on this blog.

“Nope. Where did I say that? You are just making things up now.”
Yet as requested, I’ve just shown you where you lack logic.
Since by your own reckoning you’re no exception to the list of logic lackers.
Which is likely true but certainly illogical.

A drowning man clutches at straws on his way down.
As usual you have no meaningul response to my posts.

Shapiro clearly thinks the modern theory of evolution is wrong and he says so at every opportunity. It is just disingenuous of you to pretend he does not. He characterises his theory of adative mutation as an “alternative” to the modern theory of evolution. It is not. Period.

But, Shapiro and I, after reading his book (yes!), both understand what’s going on in the immune system. The analogy to speeded up random mutation and natural selection within the organism is clearly apt and I have explained clearly what we both mean by that analogy.
We just disagree what that means for the modern theory of evolution.
You, on the other hand, are just floundering around with meaningless babble. You cannot address the essence of my arguments in any meaningful way and so you resort to word play and shit kicking.

How’s this for bullshit:
cwfong: “Shapiro says: “The immune system is itself a rapid evolutionary process, replacing one set of immune specificities with another.” Nothing in the article at all about accelerated randomness at all.”
Please explain how immune system could possibly be a rapid evolutionary process (random mutation + natural selection) without there being rapid random mutation.

When Shapiro talks about microbiology he is an excellent teacher. This is his field. When he talks outside his field, he talks rubbish. He does not understand the modern theory of evolution and therefore his criticisms of it are way off the mark. This is where he and actual evolutionary biologists part company.

‘Yet as requested, I’ve just shown you where you lack logic.
Since by your own reckoning you’re no exception to the list of logic lackers.’

Oh I know I lack logic. I got married. You show me where I have lacked logic here. I can quite accept I have done this.But quote me my original statement. Then I can see my errors and attempt to correct them.

Dirk Steele: “Psychiatric drugs to not ‘cure’ anything in a medical sense.”

And you think that makes them worthless?

I’m on long term medication to counteract a medical condition that has a genetic cause. This medication will never ‘cure’ me but it allows me to live free of some very unpleasant symptoms, some life threatening.

PharmD28 gave you another example of someone whose life changed significantly for the better following medication for their mental condition and you wave it off as if it were nothing.

Dirk, the point is that we all lack logic, and basing your opinions on their logic alone proves nothing since there’s likely to be a flaw in all our premises. Many flaws have been pointed out in your own premises. Too many for me to go back and itemize, and even if I did, you’ve already denied that they’re inaccurate. In addition, we can’t count on any consistency in your responses here. One moment you’re uncertain and the next one, you’re back to dogmatic assertions that you’re certain of. Ask yourself why and the answer might just come to you. Or not.

I didn’t comment on the Susan Rosenberg quote because that is just part of your modus operandi: to divert attention away from a discussion you are drowning in. In fact I hadn’t even gotten around to reading it. But I have now.

Here she is in her area of expertise:

“We have found that genetic recombination enzymes are required for some adaptive mutations. We are uncovering a new and unexpected molecular mechanism for mutation in nondividing cells that includes DNA double-strand breaks, recombination, DNA synthesis, and suspension of postsynthesis mismatch repair, and which occurs in a hypermutable subpopulation of the cells. The mutations are similar to those characteristic of some cancer cells. This new mutation mechanism in nondividing cells may be an important model for mutations that give rise to some types of cancer and genetic diseases, cause resistance to chemotherapeutic and antibiotic drugs, lead to pathogenicity of microbes, and participate in many other systems previously thought to follow the rules of classical growth-dependent mutation.”

What she is doing here is explaining the mechanisms that underlie what I have characterised as rapid random mutation.
Suck on it, cwfong!

“For 50 years, the world believed that mutations occur at random. The discovery of “adaptive mutation” in bacteria shook the foundation of that dogma, implying the existence of a another kind of mutation that differs from normal spontaneous mutations. The “adaptive” mutations occur when they are selected, in cells that appear not to be dividing, and had been found only in genes whose functions were selected. We are elucidating the molecular mechanism by which these mutations form.”

Here she is way off beam. There is no evidence that these mutations are not random. I trust you understand that random means: that the mutations occur regardless of whether they are helpful, harmful or neutral. This is exactly what happens in the immune system, as I described in a previous post and which I will recapitulate below:

There is RANDOM MUTATION of bits of DNA coding for antibodies (a capacity that has been built into the organism through millions of years of random mutation and natural selection of it’s evolutionary history!). I say “random” because, clealy, none of these mutations are favoured or targeted. Subsequently, the antibodies that fit the invader’s antigens precipitate reactions which feed back to increase their production at the expense of the antibodies that do not fit the invader’s antigens. That is analagous to NATURAL SELECTION.

Eat you heart out, cwfong!

If you respond to one thing, respond to the above paragraph. It is a clear refutation of the idea of DIRECTED MUTATION and a clear explanation of how it is nothing more that ordinary, everyday, garden-variety RANDOM MUTATION.

(Directed mutation is the basis of Shapiro’s attack on modern evolutionary theory and it has no basis in fact.)

I did not say that. Certain sedative drugs can be useful short term. I know that certain drugs such as insulin are critical but do not cure. But this is medical science. Psychiatric drugs do not work in the same way in that they do NOT correct a measurable demonstrable physical imbalance. And despite the advertising, SSRIs do not correct a chemical imbalance. This is marketing not science.

I did not write off drugs that PharmD28’s mother took as worthless. Read again exactly the words I wrote. Actually I am in favour of the legalisation of all drugs if people want to take them. I object only if they are forced long term.

@BillyJoe7,
“Please explain how immune system could possibly be a rapid evolutionary process (random mutation + natural selection) without there being rapid random mutation.”
Because first of all you called it accelerated random mutation which is an oxymoron. And second Shapiro explicitly explained that it was mutation directed by the organism. Any randomness is taken advantage of by the organism but essentially it doesn’t rely on randomness but engineers its own mutation process. And as Shapiro pointed out and you denied, does all this for a particular purpose. (Or will you still pretend he didn’t mention purpose and instead stressed randomness as a substitute for the organism’s direction.)

And most definitely he did not speak of rapid RANDOM mutation. There is no such thing. You can’t speed up randomness without directing it to speed up, in which case the effects become non random. And the point of the article was to explain that the mutations take effect because the organism, based on what it has learned from experience, exercises direction in the process.

You can continue proclaiming that your arguments are self-evidently superior, and believe yourself because you said it, but that’s what you always do, so what else should anyone expect. That’s how you’ve been instinctively directed to think.

Reminds me of when my university class first took a tour of the local nuthouse, and watched the keepers poke the catatonics with a stick. You could never tell when they might get angry, but we’d bet on it anyway.

Subsequently, a new diagnosis, ego-dystonic homosexuality, was created for the DSM’s third edition in 1980. Ego dystonic homosexuality was indicated by: (1) a persistent lack of heterosexual arousal, which the patient experienced as interfering with initiation or maintenance of wanted heterosexual relationships, and (2) persistent distress from a sustained pattern of unwanted homosexual arousal.

Drapetomania was a mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity. Today, drapetomania is considered an example of pseudoscience.

The most shocking information within the employee records are the evidence and documentation of hydrotherapy, electroshock, lobotomy, and psychotropic drugs. All which have been discredited today as extremely inhumane ways of treating a patient. The leading cause of insanity among the male patients was masturbation.

All this pathetic Steven Novella wants is to be the next little Buddha or a Jesus or Mohammed. He desires to have his acolytes surround and protect Him from all criticism. In the name of skepticism, He loves to organise His conferences to seek His slaves. Yet His definition of skepticism is… all those that are not ‘true believers’. We must All bow down to His greatness! And He has His devout followers… to castigate all those who disbelieve or even question Him. Why have a blog? Only to support his arrogant egotistical mind. Bla bla bla.

This is not science. This is religion. It is actually no different from L Ron. Religious wars never end.
And He feeds his followers scraps. The meek will inherit the earth. The sheep will follow.

I can fake every one of all the ‘diseases’ specified in the DSM. Every one. Trust me. No one can tell if I am telling the truth or being false about my schizophrenia or my multiple personalities. My welfare benefits depend on it. And I also believe that Karl Popper is correct. If one has no ability to tell the difference … i.e if one does not have the measures to deduce falsification or not.. then it is pseudoscience. If I pretended to have schizophrenia or adhd or MDD or anything in the DSM then no-one could prove otherwise. Compare that with scientific medicine. If i pretended to have cancer, or measles, or diabetes, or hypertension… then my claim can be falsified by science.

Executive Function = neurocognitive processes that maintain an appropriate problem-solving set to attain a later goal.

this does sound like pseudoscience to me. Or more so just doctor-ese. Even so, the researchers admit that a “diminished executive function” doesn’t appear consistently enough to explain ADHD. AFter all, it’s “heterogeneous”.

Doctors love to name things that then become disorders or diseases: social anxiety disorder, gastric reflux disease, etc.

the research appears to be just further description of what is simply a descriptive diagnosis. Like Dirk claims, there’s no biological evidence of abnormality. Differences in brain physiology are to be expected, since behavior and brain state are always correlated. Whether or not those differences are a disorder is simply a judgement call. Setting up exams to illustrate a certain inability will of course find that inability. Dr. Novella uses the argument from authority. It will probably be impossible for most here to see the fallacy, since they are closely allied, or indeed ARE, the authority: science.

But administering dangerous drugs to children is immoral. The effect it has on them is not proof of disease, but rather of normality, since those drugs have the same effect on anyone to whom they’re administered. College-age kids often attempt to be diagnosed with ADHD in order to obtain these drugs to assist them with their studies.

Saying that kids with ADHD want to focus and pay attention is irrelevant. All children want to do what the adults around them want them to do. It’s up to the adults to protect the children from harm – including unwarranted drugging. There are plenty of out-of-control kids in the schools. This isn’t the way to deal with that problem. The answers are much more difficult. It’s become desirable to give medical names to problems that we experience as individuals or a society, since that removes personal blame. Why not just remove the blame without adding the stigma of a “disorder”? This involves examining our social standards.

But then Dirk is faced with a question: as a society we’ve tried to accommodate behaviors that are troubling or even dangerous. We’ve come a long way since locking people in cages or removing parts of their brains (although we still do that more delicately of course). And admittedly there are people being drugged, shocked, etc.. every day that shouldn’t be, because they’re simply the people who’ve been dealt a rotten hand or have never found the place they belong. There is much better kind of help we could give. Aren’t we trying? i feel like we are. I feel like I’ve had the access to information and knowledge that’s allowed me to overcome some serious difficulties simply through examining my own cognition. Your indignation is important, Dirk, because there is so much of psychiatry that is still pseudoscience and is hurting people. The emotionally lost, the poor, the unfortunate in family, the mismatched in calling.

But I guess you’d say that my godparents, who were killed by their schizophrenic son after he’d lived with them for decades, were simply unwisely tolerating immoral behavior? They loved him, and with medicine, he was able to live a mostly-normal life with them. He ended up in the state psychiatric hospital for criminals. My mom worked there for 17 years as a treatment assistant until she was forced to retire after being injured while trying to protect a nurse from an attack by one of the inmates/patients. Although it was prohibited, I heard stories about the goings-on at this institution. Most of the inmates were prisoners who couldn’t hack prison life and did whatever they needed to to get transferred to this “hospital” where they lived on wards instead of in cells, and were overseen by compassionate people like my mom – who was able to empathize. I don’t think she ever saw anyone as being “mentally ill”. These people were rather: confused, lost, disenfranchised, unloved, abused, or just broke with no assistance.

We need better social supports for people who don’t have any. But what do we do with people who don’t know who or where or when they are? Who think people are possessed and need to be killed?
Perhaps you are saying no one should be called mentally ill – we should simply address their behavior. I could go along with that. So, it wouldn’t help to do away with psychiatry, because other medical doctors would take on the role of passing judgment on others behaviors. This is the authority we give doctors in our society. is that what you would change? Who would you have decide?

So, I guess i support your assessment of ADHD, and I also agree that psychiatry gives far too much resource to describing ever more subtle disorders for everyone in our society. But in the area of dangerous behavior for society, do we simply incarcerate threatening-acting individuals? If they don’t respond to this “punishment” by modulating their behavior, then what?

Finally, you will get no further with your debate here because the underlying philosophy is stilted toward that which will not see the contradiction you’ve described: that the mind is what the brain does, therefore there are no diseases of the mind, only the brain. Mind and brain are interchangeable here, until you point out that what is called a disease of the mind may show no correlate in the brain. There are long discussions on the nature of the mind/consciousness on other pages within this site.

Dirk, you’re arguing against a viewpoint that isn’t able to see its own inconsistencies. But I thank you for your attempt. If you and your loved ones have only been hurt by psychiatry, it’s understandable that you would rail against its frauds. Sometimes I think that when medicine can’t help someone too much it ends up hurting them, and that it’s only really helpful when someone is almost beyond hope, because then almost anything it can do will help. But in many ways there is always an attempt to help, and in many ways there has been help. I do believe this. It’s a horrible thing if there’s never been any help for you in any way and only harm. I’m sorry if it’s been that way for you.

It seems that there are a couple of us here who have attempted to understand your viewpoint, but are just wondering: what would you do with those among us who are apparently out of touch with reality and also apparently unhappy because of it? You probably can’t answer that because you don’t have anyway to know what might be tried before drugs, but I just think if you’re going to argue against things like ADHD (which I totally support you in), and also ECT, etc., it’s best to focus on the faults of those ideas instead of psychiatry itself, because psychiatry is all we’ve got to deal with a very tiny part of our society that simply needs help of some kind and which we’ve tried to help in a compassionate way by first calling their problems medical instead of moral. There’s much improvement needed. Probably first by limiting who is treated as a patient. So keep crying out Dirk. It’s important after all.

The emphasis was on the word RAPID and you know it.
Also, my disagreement with Shapiro is exactly that I believe (correctly) that the rapid mutation is RANDOM, whereas he believes (erroneously) that the rapid mutation is DIRECTED. So why on Earth would I have denied that Shapiro believes it is directed?

I have already explained twice now (or is it three times?) why it is random and not directed and you are still desperately trying to drag the discussion away from that explanation because you have no answer to it. That is very obvious.

Also you don’t understand the meaning of oxymoron, but that’s another story.

———————————————

cwfong: “You can’t speed up randomness without directing it to speed up”

What sort of bullshit it this?
Of course the process can run at a greater speed and still be random.
I’ve already explained to you THREE times!
You can’t just keep saying “no it can’t” and ignore my explanation!
Well you can, but it just exposes you as the disingenuous git that you are.

“And the point of the article was to explain that the mutations take effect because the organism, based on what it has learned from experience, exercises direction in the process.”

Of course that is the point of Shapiro’s article.
He believes in magic!
But of course he’s wrong and I have explained THREE times why he is wrong.
It’s hightime you responded to that explanation.

Here it is again:
“There is rapid RANDOM MUTATION of bits of DNA that code for antibodies (a capacity that has been built into the organism through millions of years of slow random mutation and natural selection of it’s evolutionary history!). I say “random” because, clearly, none of these mutations are favoured or targeted. Subsequently, the antibodies that fit the invader’s antigens precipitate reactions which feed back to increase their production at the expense of the antibodies that do not fit the invader’s antigens. That is analagous to NATURAL SELECTION.”

BillyJoe7, reverting to insults as usual when you have no valid answers. You are an incurably ignorant clueless uneducable cement headed mental midget. And that’s not even an insult.

“I say “random” because, clearly, none of these mutations are favoured or targeted.”

Clearly to who, a failed high schooler? Shapiro clearly explains that they are directed, and you’re the one that used his article as an example.

“Of course that is the point of Shapiro’s article. He believes in magic!
But of course he’s wrong and I have explained THREE times why he is wrong.
It’s hightime you responded to that explanation.”

You couldn’t explain the way to get across the road, let alone how a world famous scientist could be wrong compared to someone who pulls his opinions out of his rear end. My response to that explanation is it’s a senseless piece of crap.

If you couldn’t even understand that article, written specifically for non-scientists, you’ll never understand the subject, no matter the helper who would even want to try. Insults don’t inspire much concern for your welfare, at least not in my neighborhood. I’ll be much happier to see you ignorant for life.

Actually, it’s called Gastro-Oesophageal Reflux Disease (GORD)
(At least in Australia)
It can lead to Esophageal ulcers, Barrett’s Esophagus, and Esopahgeal cancer.
The ulcers can bleed and they can rupture.
Both ulcers and cancer can kill.

Thank you for the post. You can frame the issues better than I ever could. I know that in my frustration and in my attempts to explain I will just polarise the debate. And then take the extreme view which when I think about it I know I am wrong.

“Executive Function = neurocognitive processes that maintain an appropriate problem-solving set to attain a later goal.

this does sound like pseudoscience to me. Or more so just doctor-ese. Even so, the researchers admit that a “diminished executive function” doesn’t appear consistently enough to explain ADHD. AFter all, it’s “heterogeneous”.

Doctors love to name things that then become disorders or diseases: social anxiety disorder, gastric reflux disease, etc.

the research appears to be just further description of what is simply a descriptive diagnosis. Like Dirk claims, there’s no biological evidence of abnormality. Differences in brain physiology are to be expected, since behavior and brain state are always correlated. Whether or not those differences are a disorder is simply a judgement call. Setting up exams to illustrate a certain inability will of course find that inability. Dr. Novella uses the argument from authority. It will probably be impossible for most here to see the fallacy, since they are closely allied, or indeed ARE, the authority: science.

But administering dangerous drugs to children is immoral. The effect it has on them is not proof of disease, but rather of normality, since those drugs have the same effect on anyone to whom they’re administered. College-age kids often attempt to be diagnosed with ADHD in order to obtain these drugs to assist them with their studies.

Saying that kids with ADHD want to focus and pay attention is irrelevant. All children want to do what the adults around them want them to do. It’s up to the adults to protect the children from harm – including unwarranted drugging. There are plenty of out-of-control kids in the schools. This isn’t the way to deal with that problem. The answers are much more difficult. It’s become desirable to give medical names to problems that we experience as individuals or a society, since that removes personal blame. Why not just remove the blame without adding the stigma of a “disorder”? This involves examining our social standards.

But then Dirk is faced with a question: as a society we’ve tried to accommodate behaviors that are troubling or even dangerous. We’ve come a long way since locking people in cages or removing parts of their brains (although we still do that more delicately of course). And admittedly there are people being drugged, shocked, etc.. every day that shouldn’t be, because they’re simply the people who’ve been dealt a rotten hand or have never found the place they belong. There is much better kind of help we could give. Aren’t we trying? i feel like we are. I feel like I’ve had the access to information and knowledge that’s allowed me to overcome some serious difficulties simply through examining my own cognition. Your indignation is important, Dirk, because there is so much of psychiatry that is still pseudoscience and is hurting people. The emotionally lost, the poor, the unfortunate in family, the mismatched in calling.

But I guess you’d say that my godparents, who were killed by their schizophrenic son after he’d lived with them for decades, were simply unwisely tolerating immoral behavior? They loved him, and with medicine, he was able to live a mostly-normal life with them. He ended up in the state psychiatric hospital for criminals. My mom worked there for 17 years as a treatment assistant until she was forced to retire after being injured while trying to protect a nurse from an attack by one of the inmates/patients. Although it was prohibited, I heard stories about the goings-on at this institution. Most of the inmates were prisoners who couldn’t hack prison life and did whatever they needed to to get transferred to this “hospital” where they lived on wards instead of in cells, and were overseen by compassionate people like my mom – who was able to empathize. I don’t think she ever saw anyone as being “mentally ill”. These people were rather: confused, lost, disenfranchised, unloved, abused, or just broke with no assistance.

We need better social supports for people who don’t have any. But what do we do with people who don’t know who or where or when they are? Who think people are possessed and need to be killed?
Perhaps you are saying no one should be called mentally ill – we should simply address their behavior. I could go along with that. So, it wouldn’t help to do away with psychiatry, because other medical doctors would take on the role of passing judgment on others behaviors. This is the authority we give doctors in our society. is that what you would change? Who would you have decide?

So, I guess i support your assessment of ADHD, and I also agree that psychiatry gives far too much resource to describing ever more subtle disorders for everyone in our society. But in the area of dangerous behavior for society, do we simply incarcerate threatening-acting individuals? If they don’t respond to this “punishment” by modulating their behavior, then what?

Finally, you will get no further with your debate here because the underlying philosophy is stilted toward that which will not see the contradiction you’ve described: that the mind is what the brain does, therefore there are no diseases of the mind, only the brain. Mind and brain are interchangeable here, until you point out that what is called a disease of the mind may show no correlate in the brain. There are long discussions on the nature of the mind/consciousness on other pages within this site.

Dirk, you’re arguing against a viewpoint that isn’t able to see its own inconsistencies. But I thank you for your attempt. If you and your loved ones have only been hurt by psychiatry, it’s understandable that you would rail against its frauds. Sometimes I think that when medicine can’t help someone too much it ends up hurting them, and that it’s only really helpful when someone is almost beyond hope, because then almost anything it can do will help. But in many ways there is always an attempt to help, and in many ways there has been help. I do believe this. It’s a horrible thing if there’s never been any help for you in any way and only harm. I’m sorry if it’s been that way for you.

It seems that there are a couple of us here who have attempted to understand your viewpoint, but are just wondering: what would you do with those among us who are apparently out of touch with reality and also apparently unhappy because of it? You probably can’t answer that because you don’t have anyway to know what might be tried before drugs, but I just think if you’re going to argue against things like ADHD (which I totally support you in), and also ECT, etc., it’s best to focus on the faults of those ideas instead of psychiatry itself, because psychiatry is all we’ve got to deal with a very tiny part of our society that simply needs help of some kind and which we’ve tried to help in a compassionate way by first calling their problems medical instead of moral. There’s much improvement needed. Probably first by limiting who is treated as a patient. So keep crying out Dirk. It’s important after all.

It seems to me that, society, quite understandably and in good heart, is attempting to minimise risk of harm. To prevent the next Anders Breivik. To be better prepared to stop the next mass murderer. With ‘attenuated psychosis syndrome’?. To prevent the tragedy of suicide and identify the deeply depressed. Teenscreen? I have the same goals. I think the question is ‘where is the balance between false positives type 1 and 2 we will allow. How many innocent people should we convict in order not to let a guilty person go free. I have seen in my lifetime a huge shift.

cwfong, in his drunken stupor, thinks that boldly stating that something is true is proof that it IS true and that boldly stating the something is false is proof that it IS false.

Oh, and that reminds me…
He thinks he has proven that my understanding of special relativity and spacetime is wrong simply by boldly stating that it is wrong and posting a link to an irrelevant wiki page which apparently says so…somewhere.

Are both of you saying that the psychiatric label diminishes the person behind the label?
Is that why you don’t like the labels?
And are you saying that people should be allowed to be different from the average and treated as the persons they are, not the persons we want them to be?
That we should not be using drugs to turn people into what they are not, but to accept them as they are?

At the very least, I think we should never refer to someone as a schizophrenic, but as someone with schizophrenia. But that goes for asthma as well. You should not be defined by your disorder, disease, or label.

On another thread a poster called SARA said in response to people attending sceptical events:
“On the other hand, I found you all through the Internet. And since I’m not a good group person, I don’t have any desire to go to these events. So, having said that, maybe its not very true for everyone.”
I indicated to her that I am a fellow traveller.

Recently, I met a woman in her mid to late forties who has never married (“because no one ever asked me”), who matter-of-factly told me that she has no friends (she also has no siblings or relatives, having been adopted by an elderly infertile couple), and who wrapped my letter to her as a Christmas present (she showed it to me when I visited her just afterwards). I was very much taken by her and wanted very much to befriend her and to help her but, to my surprise, she told me that she was happy to be alone and without friends and that her wish was to eventually move with her dog to outback Australia for “solitude and quiet”.
She is certainly a strange and unusual person, but does she need a label and treatment?

‘At the very least, I think we should never refer to someone as a schizophrenic, but as someone with schizophrenia. But that goes for asthma as well. ‘

I agree with your post. Although there is much doubt about asthma it is at least a scientific medical disease. And we do not incarcerate asthmatics in prisons (mental hospitals) and force feed them brain disabling drugs. Psychiatry used to do this to those with epilepsy until thank goodness the condition was moved to neurology.

Schizophrenia is a work of fiction. Invented by psychiatrists such as Bluer, so that they can pretend to be medical doctors. I know very few here have followed my links but this one makes amusing reading. http://en.wikipedia.org/wiki/Rosenhan_experiment.

I do not know whether you have followed the news on Anders Breivik but after months of study some psychiatrists have concluded he is a paranoid schizophrenic and many have said that he is sane. I know that there are areas of doubt, but does this really happen in mainstream medical science?

Dirk Steele: “Psychiatric drugs do not work in the same way in that they do NOT correct a measurable demonstrable physical imbalance.”

Really? So you’re an expert on the actions of all psychiatric drugs on all facets of mental illness? Of course you didn’t ‘say’ that do you? But what else are we to infer from your rediculous generalisations.

Dirk Steele: “SSRIs do not correct a chemical imbalance.’

Says you. Anything to back that up with?

Dirk Steele: “I object only if they are forced long term.”

But presumably you don’t mind if they’re forced short term? Perhaps you can tell us the proportion of patients who are forced to take any psychiatric drugs? You set up this r

Dirk Steele: “Psychiatric drugs do not work in the same way in that they do NOT correct a measurable demonstrable physical imbalance.”

Really? So you’re an expert on the actions of all psychiatric drugs on all facets of mental illness? Of course you didn’t ‘say’ that do you? But what else are we to infer from your ridiculous generalisations.

Dirk Steele: “I object only if they are forced long term.”

But presumably you don’t mind if they’re forced in short term?? Perhaps you can tell us the proportion of patients who are ‘forced’ to take psychiatric drugs? Or is it the case that the vast majority of people on psychiatric drugs self medicate and do so because they have first-hand experience of the huge benefits it brings them.

‘Really? So you’re an expert on the actions of all psychiatric drugs on all facets of mental illness? Of course you didn’t ‘say’ that do you? But what else are we to infer from your ridiculous generalisations.’

Na I am not an expert. I do enjoy reading pharma literature tho. Want a laugh?

Yes. Even the Pharma companies that make them can only say ‘it is believed’ because there is no scientific evidence. There is lots of evidence that they do not work though.

‘Perhaps you can tell us the proportion of patients who are ‘forced’ to take psychiatric drugs?’

Well when I was in the mental hospital I was quickly shown the ropes. A little bit of toffee stuck in the roof of the mouth was used. Stick the pill there and poke out your tongue to show the nurse it was all gone!! Get caught though… and you had to have a long term injection. Nasty that was but luckily I never got caught! Anway look up mindfreedom or psychrights for some more horror stories….

BTW I faked my way in to do some research… not saying I am not crazy though.

“But presumably you don’t mind if they’re forced short term? Perhaps you can tell us the proportion of patients who are forced to take any psychiatric drugs?”

I think that is a really good question, that as far as I can tell you did not answer really….

What proportion of out patients are treated with psychopharmacology or various forms of therapy with noticable improvement in symptoms and perceived benefits that patients themselves desire to stay on treatment?

My mother is not forced to take her mood stabilizer and antipsychotic, but she has done it for years now, and she has gone off of it before and now does not wish to repeat this….are these medications scientifically curing her long term? It would appear not, but what appears obvious that you seem to ignore carefully, is that these medications and therapy have and continue to help prevent behaviors and states of mind in her that are undesirable to her and to others…ask her yourself…and she has gone off her meds way in the past before because she though she was cured…then she knew she had to go back on them shortly thereafter.

I wish these medications “cured” her…I even wish the meds and treatment did an even better job than they do in fixing her “woes”….but what I am darn sure of is what at this point will be the result of her NOT taking these medications that you erroneously conflate with homeopathy will result in her suffering more so significantly…she knows it, I know it, her doctor knows it….and you are in denial of such facts regarding the benefits of such treatment…or so it seems.

It is very interesting that you faked psychosis to enter in the hospital….I guess that shows that someone can fake it…I wonder how many people do fake it and trick the credulous psychiatrists? How many are not fake? How many present with suffering that is real and are forced to take these medications for the better of the person, the family, and society? How many fake it for their own strange reasons? How many are not sick, but are improperly diagnosed? All valid questions, although you seem only interested in those that you cherry pick out who either fake it or should not be receiving treatment…you ignore positive evidence that would cast doubt on your broad sweeping categorical claims that psychiatry = homeopathy…you would throw the baby out with the bathwater.

I would not say that pscyiatric care of such patients is perfect by any means, but your skepticism of psychiatry has gone so far in one direction that it is indistinguishable from cynicism IMO.

Also, what say you of prolonged exposure therapy for “PTSD”…would you deny that this form of treatment is indeed effective in reducing symptoms in such patients? If so, why is it effective?

“If one has no ability to tell the difference … i.e if one does not have the measures to deduce falsification or not.. then it is pseudoscience.”

A false dichotomy? I mean you said yourself that you admit that there are those who display these involuntary symptoms causing them to suffer…you would not deny that there are those in our society that are psychotic, etc…

Now the fact that people could falsify these “diseases” that are diagnosed for various purposes or that they can be mis-diagnosed, or perhaps even ? maliciously diagnosed or diagnosed with severe bias present….all of these facts demonstrate shortcomings of the practice of psychiatry/psychology – but it does not disprove that 1) there are those that suffer with these involuntary symptoms and that 2) there is evidence that treatment with psychiatry/psychology demonstratively improves outcomes in patients displaying these symptoms…of course if they are all faking then the research is invalid, but one has to buy into this false dichotomy to come to the same conclusion you have.

But again, you seize on the critical points and really leave off points that would cast doubt on your narrative…cherry picking.

‘I wonder how many people do fake it and trick the credulous psychiatrists? How many are not fake? How many present with suffering that is real and are forced to take these medications for the better of the person, the family, and society? How many fake it for their own strange reasons? How many are not sick, but are improperly diagnosed? All valid questions, although you seem only interested in those that you cherry pick out who either fake it or should not be receiving treatment’

In the hospital I met a few that faked it. Having a warm bed, free meals, social security money for fags and booze etc is much better than living on the streets. There were all sorts of strange people there. Even I felt quite at home after a few days. Dead easy to fake… just say you are hearing voices.

But, and this is a very big BUT.. I have never suggested that people who suffer should not receive treatment. They should have the most care society can offer. A woman I met in there was suffering from depression. Her psychiatrist had suggested ECT. I had long conversations with her and learned that she lived in a 2 bedroom house with her current partner and three sons from previous marriages. Her ‘treatment’ to me was obvious and it was not the ECT.

What I am against is the biological psychiatric model that ‘mental’ disease is caused by a brain abnormality. This is just another example of blaming the person while pretending the opposite.

Are you reading the links that I post to further your knowledge? I gave you a link to Loren Mosher and his Soteria work.

‘But again, you seize on the critical points and really leave off points that would cast doubt on your narrative…cherry picking.’

Yes I admit to that. Trouble is I do not have the time to answer all the questions posed without choosing which one I think most pertinent. And yes of course I have confirmation bias. I also admit to polarising the debate but this is only what Steven Novella has started. Things are far more gray than I portray.

I believe in the scientific method. But of course I get it wrong many times. That is the nature of science and scientists. Most of the time we are wrong.

I am just very skeptical of the position of biological psychiatry that claims that our suffering in life is caused by an ‘illness’ or disorder or disease and can be treated and cured like any other medical disease. The science of this view is actually lacking. But I do accept that the brain can be changed in size and chemistry by life events or chemicals. Lord knows how I love my whisky!

So I do question whether ADHD and its rapid rise is actually a brain disorder or actually the result of changes in the school institution over the past 50 years. The introduction of standard tests and targets, the homework and the pressures that exist on certain pupils that did not exist when I was that lazy little git of a naughty boy! This has been my experience and I know it is anecdotal but there are many who share this view. Look out for the vids I linked to earlier from Sir Kenneth Robinson. They are quite entertaining too…. but in order to understand what I am saying – which are not my views.. (I only can steal from those who have a greater intelligence than I will ever have) you need to research.

BTW…. when I used the word ‘hopeless’ earlier I meant the usage to mean ‘lack of hope’ for the future.

Dirk, you’re a nutcase that pretends he’s not a nutcase but is good at faking it. But does so for all the purposes that a nutcase needs to serve. No expert needed to see that. I suppose you’ll tell us that the doctors at the mental institutions had no idea you were faking. No, they had an idea that you were pretending to be sane and fooling them. What bothers you is that they all seemed smarter than you, and wouldn’t tell you why.

I have some wonderful memories though. I only had to see the psychiatrist for one hour a week and he spent most of that time talking about how he became a psychiatrist after reading Scott Fitzgerald’s ‘Tender is the Night’. I think he suffered from an a bit of an obsession if you ask me.

So most of the time I was left to wander about the place apart from when the nurses, who made Nurse Ratched seem like a sweet old pussy, had to administer the drugs. Now I like to experiment with the old illegal substances from time to time (One day I will tell you about my interview and experience with the ‘substance abuse team leader’) … but when I made a little complaint… well I got myself into a big ‘dispute’! Everynight at 2 a.m in the morning they would look through the little window in the door of my bedroom and turn on the light. Just to make sure I was safe and sound. They had good hearts really. Anyway when I complained that this always woke me up and I could not get a good bleeding night’s sleep all the time I was there and it made me feel very tired and irritable in the mornings… they went mad!! They told me it was another example of my mental condition. When I asked if they really had to do this… they told me that they had statistics and targets to meet and therefore had to obey those rules. Well… I did what a good red blooded male would do in those circumstances at 2 in the morning!!… but in hindsight I think it did not help me in getting out of there when I made that request.

‘Getting irritated are we? I think people got your joke about 20 pages ago, but here you are.’

No.. I am actually laughing at you. From just a quick look around here I see you post on every topic raised! Without fail. And I was called a ‘troll’ by Steven for ‘inappropriately’ commenting on just one of his! Aren’t you just a teeny bit jealous that Steven has devoted a whole subject on the views of ‘Dirk Steele the Szaszian’, but has ignored you entirely? Send me a private message and I will give you a few tips on how to rectify your failures as a troll and how to be the success that I am. It may cost you a few dollars though….

“Executive Function = neurocognitive processes that maintain an appropriate problem-solving set to attain a later goal.

this does sound like pseudoscience to me. Or more so just doctor-ese. Even so, the researchers admit that a “diminished executive function” doesn’t appear consistently enough to explain ADHD. AFter all, it’s “heterogeneous”.

Doctors love to name things that then become disorders or diseases: social anxiety disorder, gastric reflux disease, etc.

the research appears to be just further description of what is simply a descriptive diagnosis. Like Dirk claims, there’s no biological evidence of abnormality. Differences in brain physiology are to be expected, since behavior and brain state are always correlated. Whether or not those differences are a disorder is simply a judgement call. Setting up exams to illustrate a certain inability will of course find that inability. Dr. Novella uses the argument from authority. It will probably be impossible for most here to see the fallacy, since they are closely allied, or indeed ARE, the authority: science.

But administering dangerous drugs to children is immoral. The effect it has on them is not proof of disease, but rather of normality, since those drugs have the same effect on anyone to whom they’re administered. College-age kids often attempt to be diagnosed with ADHD in order to obtain these drugs to assist them with their studies.

Saying that kids with ADHD want to focus and pay attention is irrelevant. All children want to do what the adults around them want them to do. It’s up to the adults to protect the children from harm – including unwarranted drugging. There are plenty of out-of-control kids in the schools. This isn’t the way to deal with that problem. The answers are much more difficult. It’s become desirable to give medical names to problems that we experience as individuals or a society, since that removes personal blame. Why not just remove the blame without adding the stigma of a “disorder”? This involves examining our social standards.

But then Dirk is faced with a question: as a society we’ve tried to accommodate behaviors that are troubling or even dangerous. We’ve come a long way since locking people in cages or removing parts of their brains (although we still do that more delicately of course). And admittedly there are people being drugged, shocked, etc.. every day that shouldn’t be, because they’re simply the people who’ve been dealt a rotten hand or have never found the place they belong. There is much better kind of help we could give. Aren’t we trying? i feel like we are. I feel like I’ve had the access to information and knowledge that’s allowed me to overcome some serious difficulties simply through examining my own cognition. Your indignation is important, Dirk, because there is so much of psychiatry that is still pseudoscience and is hurting people. The emotionally lost, the poor, the unfortunate in family, the mismatched in calling.

But I guess you’d say that my godparents, who were killed by their schizophrenic son after he’d lived with them for decades, were simply unwisely tolerating immoral behavior? They loved him, and with medicine, he was able to live a mostly-normal life with them. He ended up in the state psychiatric hospital for criminals. My mom worked there for 17 years as a treatment assistant until she was forced to retire after being injured while trying to protect a nurse from an attack by one of the inmates/patients. Although it was prohibited, I heard stories about the goings-on at this institution. Most of the inmates were prisoners who couldn’t hack prison life and did whatever they needed to to get transferred to this “hospital” where they lived on wards instead of in cells, and were overseen by compassionate people like my mom – who was able to empathize. I don’t think she ever saw anyone as being “mentally ill”. These people were rather: confused, lost, disenfranchised, unloved, abused, or just broke with no assistance.

We need better social supports for people who don’t have any. But what do we do with people who don’t know who or where or when they are? Who think people are possessed and need to be killed?
Perhaps you are saying no one should be called mentally ill – we should simply address their behavior. I could go along with that. So, it wouldn’t help to do away with psychiatry, because other medical doctors would take on the role of passing judgment on others behaviors. This is the authority we give doctors in our society. is that what you would change? Who would you have decide?

So, I guess i support your assessment of ADHD, and I also agree that psychiatry gives far too much resource to describing ever more subtle disorders for everyone in our society. But in the area of dangerous behavior for society, do we simply incarcerate threatening-acting individuals? If they don’t respond to this “punishment” by modulating their behavior, then what?

Finally, you will get no further with your debate here because the underlying philosophy is stilted toward that which will not see the contradiction you’ve described: that the mind is what the brain does, therefore there are no diseases of the mind, only the brain. Mind and brain are interchangeable here, until you point out that what is called a disease of the mind may show no correlate in the brain. There are long discussions on the nature of the mind/consciousness on other pages within this site.

Dirk, you’re arguing against a viewpoint that isn’t able to see its own inconsistencies. But I thank you for your attempt. If you and your loved ones have only been hurt by psychiatry, it’s understandable that you would rail against its frauds. Sometimes I think that when medicine can’t help someone too much it ends up hurting them, and that it’s only really helpful when someone is almost beyond hope, because then almost anything it can do will help. But in many ways there is always an attempt to help, and in many ways there has been help. I do believe this. It’s a horrible thing if there’s never been any help for you in any way and only harm. I’m sorry if it’s been that way for you.

It seems that there are a couple of us here who have attempted to understand your viewpoint, but are just wondering: what would you do with those among us who are apparently out of touch with reality and also apparently unhappy because of it? You probably can’t answer that because you don’t have anyway to know what might be tried before drugs, but I just think if you’re going to argue against things like ADHD (which I totally support you in), and also ECT, etc., it’s best to focus on the faults of those ideas instead of psychiatry itself, because psychiatry is all we’ve got to deal with a very tiny part of our society that simply needs help of some kind and which we’ve tried to help in a compassionate way by first calling their problems medical instead of moral. There’s much improvement needed. Probably first by limiting who is treated as a patient. So keep crying out Dirk. It’s important after all.

I think this is a very effective branch of psychiatry, with no drugs.’

Your comment ‘Setting up exams to illustrate a certain inability will of course find that inability.’ has reverberated around in my brain since I read it. Thanks! So if we could apply this to society in general… those that are ‘successful’ in life will need to measure their success against the failures in society. Failures are needed in order to define ‘success’. So we, as a groupthink, must be able to define and point out ‘objectively’ those who fail in life. Or make them up! To booster our own ‘ego’. And it is those who need the authority and control over others valididated, that need this measurement the most? Hitler? I need to re-read the Tao Te Ching (Arthur Waley translation?)

and:
1. I can’t similarly extrapolate from my own statement about exams that “we” as a society need to objectively judge some as failures in order for some to feel successful. I know that there are people who don’t feel successful unless they can compare themselves to the unsuccessful, but it’s too much for me to stretch that to saying we are acting as a society in that way. I think it’s more likely that we hold a communal idea about how people ought to act, what they should desire, etc. – and I think we tend to ostracize or even punish those who don’t conform. i don’t think this is conscious. I think it’s if and when an individual becomes conscious that they may be ostracizing or punishing someone just for being different, then they may be enlightened to reform. I optimistically see that there has been profound improvement in our culture along these lines. And I see from the information that you’ve shared that certain psychiatric diagnoses have historically been exposed as pseudoscience.

2. I’d like to share with you my thoughts about you and your experiences:

you’ve spent time in a nuthouse. You didn’t belong there. You saw that very few people belong there. You are justifiably angry. You’ve come to understand that some people have the power to cause other people to suffer. Now you’ve even more justifiably angry. You believe Dr. Novella is a pompous physician who’s unable to see or accept that psychiatry is a pseudoscience. The more you struggle to point it out, the more authoritative the dismissal of your views becomes.

You’d like to change people’s opinions about psychiatry. But you should realize that people don’t form their opinions by reading blogs. Those who come pre-equipped with a tendency to believe the argument from authority will reinforce their beliefs with Dr. Novella’s offering of journal citations. Those who can see your viewpoint will undoubtedly understand, and agree or defy you based on their own experiences and your replies to those.

But in the end, it’s a personal journey for you. There are better nuthouses than the one you were in. And there are far worse. But society doesn’t act as an individual acts, or even as a group within society acts. The more insulated the educated become from the travails of society the less able they are to understand the very things they have the power to control. This is the biggest problem with psychiatry. Any doctor who’s been able to sustain the financial and time investment to become a psychiatrist can’t possible relate to the dregs of society – people like you and me. You understand, now you need to act within the confines of your own power to control. “Be the change you want to see in the world.” (Ghandi) and also from Ghandi:
“The weak can never forgive. Forgiveness is the attribute of the strong.”
Forgive those who have hurt you and try to change the situations that allowed them to hurt you. You will be helping everyone. ‘cuz hurting others is bad karma! And if you can’t get past it you will end up hurting other people too.

I can tell that your cutting wit has always served you well in defense of your dignity. But whatever you set up to defend will be continually accosted. I applaud and thank you for your exposure of the naked emperors: ADHD, ECT, the little book with all the disorders listed so scientifically, etc. But you risk undermining your own argument by sarcastically engaging those who have no interest in understanding. Human life is horribly tortured. We don’t have good solutions for our problems – including the problem of inequality of money and power. Why not work on finding some?
(here I must confess that my days of fighting for any cause but that of my own soul are long past – thanks for pointing me back to “the way” – but it almost caused me to make no reply 🙂

I mean, I have a number of criticisms of psychiatry…and I think you do as well, and many of them NO DOUBT have significant validity…

However, it isnt that all the “Novella followers” are going to not hear any of these criticisms and find them useful, but your message is distracted by severely dichotomous and over-generalized points made…like that psychiatry is the equivalent to homeopathy…I keep challenging you on this equivalency…I do not think you have maintained it very well at all…you conceded that some folks need psychiatry and the chemicals used…but with the same breath before you say that psychiatry equals homeopathy….well, I cannot think of of a situation where I would recommend homeopathy, period….I can think of plenty of situations (and you have pointed out many) where psychiatry is not needed or is used innapropriately, but there are many I could cite where it is…

Mlema pointed out nicely too that there are various “nuthouses”, some good, some bad, some stellar, some horrid….There is not a homeopath that is useful for one person at all.

If Dirk your goal is to point out issues worth debate within psychiatry, fine…but within your own arguments you have openly taken some positions that simply are not sustainable in the face of evidence and logic….homeopath = psychiatry particularly….or that psychiatry is pure psuedoscience…

Im glad that you admit your confirmation bias…but are you really admitting it? I mean, at one point you say that pyschiatry is simply psuedoscience, equivalent to homeopathy or crystal healing, but then you admit that there are those that need psychiatric care:

“But, and this is a very big BUT.. I have never suggested that people who suffer should not receive treatment. They should have the most care society can offer.”

Again, I cannot think of a situation where I would recommend homeopathy…but you and I seem to agree that at least there seems to be some uses for psychiatry…

Perhaps this was all an attempt to be “polarising”…ok, you succeeded, but now it is clear the equivalency red herring that you had maintained is just that, an attempt to polarize the debate, but that you yourself seem to not believe by your own words here.

Others have also criticised me for my polarisation and I do accept it. I have actually made things more difficult for myself aand probably obscured rather than clarified. I obviously let my emotions run away a bit and that is something I may have learned and will try to compensate for in future. Trouble is I am not Szasz and I do not have his intellect. He would probably be horrified with me. 🙁

But let me try in my own inaquate way to try to convey what Szasz means when he states that mental illness is a metaphor. This is not, as Dr. Novella states mere semantics. I do not know whether you are aware of the work of George Lakoff who shows how all our language is metaphorical. But it is difficult for us to see this. For example the word ‘tax-relief’ is also a metaphor which frames the way we may look at tax. Stopping paying tax is a ‘relief. therefore tax is bad. The economy is ‘sick’.

The noun ‘mind’ did not exist until the 17thC from the verb ‘minding’ as in minding my business. The metaphor ‘mind disease’ framed the debate resulting in the term mental illness. Now that the mind has become synonymous with the brain, conditions we suffer in life are now brain diseases. For 150 years psychiatrists have thus prodded and explored the brain to find the cause for a mental disorder. They have failed. Totally.

Supposing we had originally, just as an anology here, defined a persons suffering as a ‘failure in creating a fulfilling social identity’ then probably the ‘cure’ of this would not be in the medical domain at all. But in society. We might then be looking at problems in society as a way of curing ‘brain disease’ This is more my view. I am of course aware that stress and environment can change the brain. Does the ADHD child with the smaller lobes suffer from a genetic biological disorder or is he not suited to the modern institution of schooling now adopted, which then causes brain changes resulting from the stress he experiences? Others have argued this point and I have given links. Cause or correlation argument I suppose.

This is why Szasz calls attention to those ‘mental illnesses’ as existed in the past such as drapetomania, and homosexuality. It was a change in society that ‘cured’ the disease.

Now psychiatry attempts to see itself as a science but I call it a psedoscience in the same way I would call politics a pseudoscience. My comparison with homeopathy therefore probably misleads here to. Sorry.

“Science is harder to apply to psychiatry than to other medical disciplines. Mental illness can’t be studied like pneumonia. (…)

Modern psychiatry, with its psychotropic medications and psychotherapies, is not as scientific or as effective as we would like, but it has undeniably saved lives and improved the quality of life of countless sufferers. Instead of bashing psychiatry for its faults, we should build on psychiatry’s successes and make it ever more science-based. (…)

A further point to try illustrate my ideas. I did state this in a previous post but it was completely ignored by all.

In China, a country of one billion people, there is a mental illness, that many suffer from,described in their version of the DSM as.

Zou huo ru mo (走火入魔) or qigong deviation (氣功偏差): perception of uncontrolled flow of qi in the body. (Qi can be loosely translated as ‘life force’.)

Now chinese neurologists have studied the brain and found that it may be a genetic disorder, or that it could be related to the size of the frontal lobes or even the amount of grey matter. It has been speculated that a chemical imbalance is involved or a problem with the neurotransmitter receptors. It has been agreed that it is most likely a heterogenous disorder. Much research has been done using fMRIs and the latest technology. Some would say that it is even underdiagnosed and plans are in place to screen everybody to prevent this harm in chinese society. Pharma companies have produced a number of drugs that seem to alleviate symptoms, and ECT has been shown to be effective. There is more research to be done but scientists claim that the cure is just around the corner if more money could be made available to the researchers.

Can you give me an answer why this ‘brain disease’ is completely unknown in the US.? No person in the west suffers from this neurological disorder. Why is that? How could this be?

PharmD28,
For myself, I regret characterizing psychiatrists as unable to relate — I shouldn’t generalize. It’s all about the level of compassion any individual can bring to the role they play. There are plenty of psychiatrists earnestly trying to help people who, by almost anyone’s standards, need help to cope with life. Perhaps the problem comes more from academia – always attempting to categorize and institutionalize the nature of our problems. This can happen in a dehumanizing way that undermines the goal of helping individuals. There are not too many more damaging things than diminishing a person’s self-image, which a label of “mental illness” certainly does. “Mentally ill” definitely carries a stigma in our society. And in a bad setting, those bearing that label are not treated well.

You and I have both seen that drugs can be critical in treating psychiatric patients. But I’m with Dirk as far as admitting that they are prescribed way too often simply for the sake of behavioral control in an institutional setting. Mostly, I think it’s just important to maintain a critical mind and not simply grant carte blanche to medical science when it comes to dividing our kids and our society into “sick” and “healthy” with regards to cognition and behavior. There’s a lot of misleading information about these drugs/treatments and their side effects too.

I feel like I want to say too that people who are having emotional or cognitive challenges, but who are in good possession of their identity, may too often be encouraged to think of themselves as “having a disorder” which can and should be treated with drugs. While this removes self-blame, it may also remove the belief that the individual can do something for himself – examine his thoughts, which form attitudes, which effect emotions, which effect thoughts, etc. (can you tell I’ve spent a lot of time in the self-help section of the library?) 🙂

Dirk’s philosophy may be divisive, but I personally think that having the argument is worthwhile – and having Dr. Novella illustrate one polarity (mental illness is a scientific medical condition when diagnosed by psychiatrists) and Dirk illustrating the other (psychiatry is pseudoscience) is how we get to have the argument.

“Perhaps the problem comes more from academia – always attempting to categorize and institutionalize the nature of our problems.”

Mlema, I think much of the excessive criticism of psychiatry (some is certainly deserved) over its history is the lack of perspective that it was/is a larger societal problem over this time. In this context, the work of “academia” furthers our understanding… do you think the stigma of mental illess
is really worse then in the past? There is clearly less of a stigma, in general.

“But I’m with Dirk as far as admitting that they are prescribed way too often simply for the sake of behavioral control in an institutional setting.”

Hmm, and this is based upon… some data? …perhaps personal experience? …perhaps nothing at all?

“having Dr. Novella illustrate one polarity (mental illness is a scientific medical condition when diagnosed by psychiatrists) and Dirk illustrating the other (psychiatry is pseudoscience) is how we get to have the argument.”

That is how we get to argument, but it is also how we get to a false balance. Operating as if there are 2 equivalent perspectives here, and there is not. That is not to say that there isn’t a discussion worthwhile about the treatment of mental illness, but it certainly isn’t the one you describe

“But I’m with Dirk as far as admitting that they are prescribed way too often simply for the sake of behavioral control in an institutional setting.”

Mlema, I forgot to elaborate my last point about your basis for this statement. Keep in mind that this is a fairly highly regulated aspect of healthcare in most of the US (certainly where I am), and the purpose of the regulation is largely to avoid the inappropriate use in an insitutional setting. Your criticism was more valid decades ago. Again, what are you basing your assertion upon?

Probably based on what is happening in schools (US kids are the most drugged anywhere in the world), Children’s foster homes, Elderly care homes, Prisons and other correctional institutions, Mental hospitals, Care in the community homes. Everywhere where people’s behaviour needs to be controlled. This is far more prevalent now than ever it was decades ago.

‘do you think the stigma of mental illess is really worse then in the past?’

If you think telling kids who do not fit into school, (or the homeless and the dispossessed, or those that don’t fit into todays consumerist society,etc etc) that they have an incurable brain disease and will have to take toxic drugs for the rest of their lives, that their ‘personality’ is thus damaged, not the society….then I do not know what you mean by stigmatising.

Ive watched part 1/3 of the szasz video you posted that was some form of podcast…so far it only confirms much of what you said…although szasz seems to even more categorically dismiss psychiatry than even you….you distanced yourself from the analogy between homeopathy and psychiatry, but there has been no evidence so far that szasz distances himself as such.

When talking about an “apparnetly schizophrenic patient”, his response seemed to be one of a few possibilities:

1) they are lying
2) they are not lying, but they are responsible for these thoughts and can change them through psychoanalysis or some other form of non-pharmacological therapy
3) and he did not necessarily come out and say this, but I got the feeling that if such a patient chose suicide, he would find this a reasonable outcome…he did suggest clearly that it is a reasonable option for depression. It would appear that in no case he would advocate for psychiatry (or psychopharmacology)

When I try and relate these thoughts with that of my basic understanding of the literature regarding psychosis and such…and with my own personal experience in my own family (my mother) – his advice induces severe skepticism…for reasons we have all seemed to talk about for like 400 posts 🙂

But I think it is worth pointing out that while you seem to regret taking a “polarising stance” here, I find the position of Szasz indeed the root of the polarity that you now seem to regret…he does seem to have the strongly held categorical stance regarding the totally categorical statement that psychiatry = pseudoscience…period….no ifs ands or buts. So why be apologetic for your stance now Dirk? Why agree in part even with some of the slight critiques of Mllena? You mine as well double down and be more like Szaz, which is most of your arguments within this thread…

“Dirk’s philosophy may be divisive, but I personally think that having the argument is worthwhile – and having Dr. Novella illustrate one polarity (mental illness is a scientific medical condition when diagnosed by psychiatrists) and Dirk illustrating the other (psychiatry is pseudoscience) is how we get to have the argument. ”

I have re-read what Dr. Novella has written on this topic…I am not exactly sure boiling it down to “mental illness is a scientific medical condition when diagnosed by psychiatrists” is a good idea…or that it is nearly representative of his views on the matter.

I think Mlena that comparing Dr. Novella and Szasz/Dirk as euqal opposite polarities in this matter is a false equivalency….as far as I can tell, most of what Dr. Novella seems to be responding to is the “divisive” points that Szasz et al are making?

If Dr. Novella was coming out saying something like “psychiatry is now perfect, they have it all figured out, they know things absolutely perfectly, and their final word on these matters is based in as tangible of science as say infectious disease or cardiology” then I would agree that his commentary would be the polar opposite of Szasz…not sure that is what it is at all though..

ccbowers,
well, even though my comment was addressed to PharmD28, I’m happy to reply to your questions 🙂

“…I think much of the excessive criticism of psychiatry (some is certainly deserved) over its history is the lack of perspective that it was/is a larger societal problem over this time. In this context, the work of “academia” furthers our understanding… do you think the stigma of mental illess
is really worse then in the past? There is clearly less of a stigma, in general.”

It’s always impossible to have a clear perspective about the present time until it’s passed. Relative to the past, i think our perspective is clearer and there is less stigma. I hope that relative to the future, out present perspective and stigmatization will be worse.
Academia informs practice – therefore, probably responsible for the conceptual foundation of both advances and abuses. I was naming categorization and institutionalization of illness as abuses in this case.

“… and this is based upon… some data? …perhaps personal experience? …perhaps nothing at all?”

I am basing my statement (which was framed as an opinion of agreement with Dirk) upon personal experience of myself and others and on observation. I think that’s all I really need to form an opinion. If you’re suggesting that my opinion is invalid against a consensus of psychiatrists, who inevitably have claimed at each stage that treatment is appropriate as applied – what can I say? We each give credence to various claims based on our personal beliefs. What data might I find wherein psychiatrists as a group have admitted to prescribing drugs unnecessarily? Have some impartial studies been conducted there? I would be interested. Perhaps I would change my opinion.

“That is how we get to argument, but it is also how we get to a false balance. Operating as if there are 2 equivalent perspectives here, and there is not. That is not to say that there isn’t a discussion worthwhile about the treatment of mental illness, but it certainly isn’t the one you describe”

What is it then? You seem angry that I’ve characterized Dr. Novella’s stance as being an absolute. Defending the medical validity of ADHD with something like “executive function” – which I’m sure is a valid psychological concept – doesn’t impress me as being very scientific with regards to the physiological functioning and anatomy of the brain. If you could re-phrase Dr.Novella’s viewpoint in a way that seems less absolute, again, I will reconsider my opinion.

“this is a fairly highly regulated aspect of healthcare in most of the US (certainly where I am), and the purpose of the regulation is largely to avoid the inappropriate use in an insitutional setting. Your criticism was more valid decades ago. Again, what are you basing your assertion upon?”

The administration of psychotropic drugs has always been highly regulated. It’s my understanding that they must be prescribed by medical doctors, yes? But who decides if they’re inappropriately used? Other medical doctors? But, true also, patient’s rights workers. So, possibly some improvement over the years. I still contend they’re over-prescribed. The assertions I make are based on my observations as a rational humanistic skeptic.

“I have re-read what Dr. Novella has written on this topic…I am not exactly sure boiling it down to “mental illness is a scientific medical condition when diagnosed by psychiatrists” is a good idea…or that it is nearly representative of his views on the matter.

I think Mlena that comparing Dr. Novella and Szasz/Dirk as euqal opposite polarities in this matter is a false equivalency….as far as I can tell, most of what Dr. Novella seems to be responding to is the “divisive” points that Szasz et al are making?”

Perhaps you are right. My reply to ccbowers above answers the same sort of complaint about my comments.

‘although szasz seems to even more categorically dismiss psychiatry than even you….you distanced yourself from the analogy between homeopathy and psychiatry,’

I only distanced myself because I realised it was causing a misunderstanding between us. I still have the same views as Szasz.

I am beginning to understand that it is very difficult for some to grasp what Szasz is saying when he states the term ‘mental illness’ is a metaphor. The metaphorical nature of our language which frames how we perceive our reality is mostly unconscious to us. Which is why I suggested looking at the work of George Lakoff. ‘Metaphors We Live By’ is a good start.

Let me try give another example as a fictional account to try show what can happen when a metaphor is literalised.

Broken Heart Disease is a serious condition. It is has a specific set of clinical symptoms, it causes much distress to many especially young people. Some people even die from it. It has been shown that it has been under-diagnosed and a Teenscreen campaign has been successfully organised. Cardiovascular physicians have spent much time and effort studying the physiology of the heart in order to find a cure. Latest studies using the latest technology have shown that it may result from a genetic disorder. Also fMRI scans have suggested that it may be caused by an enlargement of the pulmonary arteries while others have suggested it is an issue with the superior vena carver. There is good evidence too that the Sinus Rhythm causes certain cardiac arrhythmias which may be involved . This disease is heterogenous. The days are long past when heart surgeons performed unnecessary operations but electric shock treatment or defibrillation has proved to be beneficial. Nowadays Pharma companies have produced an extensive range of drugs which despite some serious side effects, have been shown to be effective. It is believed that the cure for this debilitating disorder will be found soon. There are some, who actually claim that the whole field of BHD is not actually a medical disease but is a pseudoscience but obviously these are ‘deniers’ and their arguments akin to creationists.

By the way, I do appreciate your efforts to try to understand the debate. Unlike most others here. You have at least listened to Szasz and you may find the other two parts of his radio interview interesting. By the way i think you may have misunderstood his views on suicide which political and nothing to do with science. The third part is devoted to a criticism of his views by two psychiatrists. Although they diagree with Szasz they do acknowledge that he is not a ‘crank’ as Steven Novella portrays him.

Szasz is a philosopher of psychiatry and not a clinical physician. You will not find in his works some of the answers you may be seeking. There are myths that underpin all societies and that may not be recognised at the time. This is more an anthropological and cultural view rather than a scientific argument. We can all look to the past and say, for example, why did society accept the view that witches existed and were real and should therefore be eradicated. We look back and say ‘how absurd’ and congratulate ourselves on our progress. But we live by similar myths that in the future will be seen as absurd too. We just cannot see this yet. I strongly believe in using the scientific method as the only method to further our understanding of reality. One of my intellectual heroes is Karl Popper, who was a supporter of Szasz! If Giordano Bruno was alive today he would be locked up in a mental institution, and diagnosed as having a ‘brain disease’ and not burned at the stake. (so I think society is making some progress here).

‘but I got the feeling that if such a patient chose suicide, he would find this a reasonable outcome’

I think you slightly misrepresent his ideas here. This is an ethical dilemna. If, for example, I decided that my life was far more about experiencing suffering than happiness and that I wanted to end it, then what should society do? Of course you would try to prevent me. You would talk to me and explain to me that life does not have to be like this. You could even lock me away to prevent me from doing myself harm. You could drug and sedate me. At what point would you say… well this person wants to die and I have to let him? After two years? After a lifetime? But this is an existential issue and not a medical one. After a time you must start to question the validity of your authority over me. Do you have more rights over my life than I have? It is a tragedy that anyone can find themselves in the position that they think their life is ‘worth less’ than death. Whole religions are devoted to this debate. Jesus, the great healer!, suffered for our ‘sins’ and commited suicide in order to ‘save’ us. There is an obvious unconscious relationship between our abstract concepts of ‘sin’ and ‘disease’. It is very difficult for us to understand this. Which is why the ‘evil’ Breivik is considered to have a ‘mental illness’ considered to be a brain disease. So the debate I am having with Steven Novella is not even a question about which scientific view is better than any other. It is much deeper than this.

‘But I think it is worth pointing out that while you seem to regret taking a “polarising stance” here,’

Yes I regret taking a polarising stance here in the same way that Giordano Bruno did! I should act more like Galileo Galilei. To argue my view step by step…. is the better way.

Now you have been ‘sort of’ asking me questions about your mother. I am not qualified and will never offer any advice on situations I have no knowledge of. You must do your own research. As the Buddha said ‘I can only point the way.’ i.e I am not able to teach you because you have to have your own unique experience in order to fully understand.

So what I am about to say is all hypothetical.

Language is metaphorical. If you understand this.. then what are you standing under? If someone tells you a joke that you do not laugh at.. is it the inadequacy of the joke or of you for your lack of comprehension? It is a well known fact that we do not find the jokes of people we dislike at all funny. Have you experienced this? I have a total belief that the experiences of an individual are a ‘truth’ of their experience of life. I will never devalue people’s thoughts because I do not understand them. Let alone say they have a brain disease! They may seem crazy to me in the same way that QED appears insane to everyone. But I cannot explain more of this in enough detail in a blog comment. And I am rambling now.. sorry.

Interviewer: “It sounds like you’re arguing that ‘nothing’ is really a quantum vacuum…Why should we think of it as nothing?”

Our resident idiot, cwfong, claimed that as well (bolded bit) and, unfortunately, our host Steven Novella chimed in later to say that he had spoken with Lawrence Krauss and that he had confirmed his nothing was a quantum vacuum. I replied that he was probably speaking within a specific context – or before he had written his book – because, in his book, he goes a couple of steps further in his description of nothing.
Now, here is Lawrence Krauss himself:

Krauss: “That would be a legitimate argument if that were all I was arguing…When I talk about empty space, I am talking about a quantum vacuum, but when I’m talking about no space whatsoever, I don’t see how you can call it a quantum vacuum. It’s true that I’m applying the laws of quantum mechanics to it, but I’m applying it to nothing, to literally nothing. No space, no time, nothing. There may have been meta-laws that created it, but how you can call that universe that didn’t exist “something” is beyond me. When you go to the level of creating space, you have to argue that if there was no space and no time, there wasn’t any pre-existing quantum vacuum. That’s a later stage. ”

Of course both our resident idiot and our host (sorry, Steve, you must have misunderstood him) admitted they had not read the book. I, of course, had read the book in its entirety and knew exactly what was in it. Now this has been confirmed the author Lawrence Krauss himself.

I understand why you are doing this but I wish you would stop. Most people reading this ( and any discussion) will first go to the bottom of the comments section. They will then see there your argument with cwfong… and then give up reading any further. Thus you are undermining the discussions on every thread. For every person that has bothered to think and take time to make a point …you are shouting over them. This is trolling. I understand your passion about exposing this guy as a fake but let others take over now. You do not need to protect us further. We are adults.

Let me try give another example as a fictional account to try show what can happen when a metaphor is literalised.

Broken Heart Disease is a serious condition. It is has a specific set of clinical symptoms, it causes much distress to many – especially vunerable young people. Some people can even die from it. It has been proved that it has been under-diagnosed and a Teenscreen campaign has been successfully organised in order to prevent it. Cardiovascular physicians have spent much time and effort studying the physiology of the heart in order to find a cure. Latest studies using the latest technology have shown that it may result from a genetic disorder. Also fMRI scans have suggested that it may be caused by an enlargement of the pulmonary arteries while others have suggested it is an issue with the superior vena carver. There is good evidence too that the Sinus Rhythm causes certain cardiac arrhythmias which may be involved . This disease is heterogenous. The days are long past when heart surgeons performed unnecessary operations but electric shock treatment or defibrillation has proved to be beneficial. Nowadays Pharma companies have produced an extensive range of drugs which despite some serious side effects, have been shown to be effective. It is believed that the cure for this debilitating disorder will be found soon. There are some, who actually claim that the whole field of BHD is not actually a medical disease but is a pseudoscience but obviously these are ‘deniers’ and their arguments akin to creationists.

BJ7 –
I was going to reference that interview, but I was a bit afraid of restirring that pot, but since you brought it up: I’m not sure which of you are correct, because I’m not even sure your disagreement. Either way Krauss does not come across very well in the interview:

“But I don’t really give a damn about what “nothing” means to philosophers; I care about the “nothing” of reality. And if the “nothing” of reality is full of stuff, then I’ll go with that.”

Umm OK. I’m not sure what this is supposed to mean. The nothing of philosophy is trying to describe the nothing of reality, and if we are talking about different meanings of nothing, then that is a legitimate issue. Lets define terms and then go from there, but he shouldn’t dismiss the concept because he doesn’t like the implications of it, or who is saying it. He comes across of being dismissive of a legit point.

“I don’t think I argued that physics has definitively shown how something could come from nothing; physics has shown how plausible physical mechanisms might cause this to happen.”

I see you have made extensive use of my previous book ‘The Art of Trolling’ which came out with fantastic aclaim five years ago. The proceeds of which allowed me to retire and thus be even more able to refine the art. I remember fondly the old days and the fun we had to see who could be first to get a geek to type ‘Godwin’s Law’ in a comment. It was so easy then and how we laughed!

I see you have made good use of chapter 3 in my book entitled ‘Inventing the Dual Personality ‘. You know.. where I explained how to create one ‘dumb’ and one ‘clever’ persona and then argue the f**k on every single thread possible. Each one of your virtual identities could even make friends and soon you could have the whole blog site polarised into opposing fighting groups. It was, I think a great breakthrough in scientific trolling and I should have received more awards than I did… to be frank. I can see you have also made use of the audio CD that came free with the book which offered far more value for money than mediocrity available like this.

Anyway this is old hat now. Normals are starting to become aware of these techniques – probably because of the amazing success of my book! Very few at the moment I know, but the numbers will soon start to grow. (According to my accountant’s statistical analysis at least.)

So. How does one retain one’s cutting edge. Become one of the new pioneers and share in the accolades and salutations that will inevitably follow from your fellow trollers. Gain more respect than you will ever deserve and reap the greatest conglomorations that you know you are entitled to!

So. Just for today, for you only, I am offering you a once in a lifetime, never to be repeated offer of a massive 5% discount of my book “Dirk Steele’s Seven Essential Strategies for Successful Trolling. ” As endorsed by such renowned luminaries as Dr Steven Novella ‘This book changed my brain/mind!’ and Dr Thomas Szasz ‘Made me believe in the concept of mental illness!’. Includes ‘How to time your troll comments to obfuscate your duplicity!. Act Now! You will only regret in life that which you never did!

Dirk Steele is available for public lectures, radio, podcast, or other media appearances. At a price.

“I’m not sure which of you are correct, because I’m not even sure your disagreement.”

cwfong insists that what Krauss means by “nothing” in his book “The Universe from Nothing” is “a quantum vacuum”. But cwfong has admitted that he has not even read the book. He watched the video Krauss made in 2009. But Krauss wrote the book in 2012, and the book contains more detail and extends his meaning of “nothing” at least a couple of steps further. As he says in that interview:

Krauss: “When I talk about empty space, I am talking about a quantum vacuum, but when I’m talking about no space whatsoever, I don’t see how you can call it a quantum vacuum…It’s true that I’m applying the laws of quantum mechanics to it, but I’m applying it to nothing, to literally nothing. No space, no time, nothing.”

In other words he has gone beyond the “nothing” of a “quantum vacuum” – which occurs in empty space – to the nothing of no space and no time.
He then goes further to explain that the laws of physics – which are necessary to convert no space and no time into the empty space of a quantum vacuum – could have evolved in a multiverse.
Finally he dismisses the philosophical concept of “nothing” as being nothing worth considering.
So he goes at least two, if not three, steps further in his book than he did in his video.

I have tried to explain this to this idiot, but even now he insists on being an imbecile by presuming to tell me what is in a book he has not even read and that I have now read twice. (Unfortunately Steven Novella made the same mistake, but that is another story)

To be clear, at no stage have I agreed with what Krauss said in his book. The argument was about what he said, not whether he has made his point. In the interview he unfortuntely rolls all philosophers into one. He should have distingished science-based philosophers from armchair philosophers. He was particularly upset by one philosopher who panned his book without giving any indication that he had even read it. That philosopher made the same mistake as cwfong! He presumed Krauss was taking only about a quantum vacuum. Very likely he had only seen the video as well.

Here is Krauss apologising to the science-based philosophers for dumping them in with the others:

Kauss talked to Dr. Novella after the video and the book came out, as well as having given many interviews to others AFTER the controversy engendered by the book, In every instance he has said that he was not saying that something came from absolutely nothing. BillyJoetistic is slyly trying to shift his story, now arguing that he was talking about a quantum vacuum as empty space and not about no space whatsoever. The bottom line is that a quantum vacuum, if such a thing exists, is not existing in no space whatsoever. And further, it is NOT at all a form of nothing.

From Wiki: “In quantum field theory, the vacuum state (also called the vacuum) is the quantum state with the lowest possible energy. Generally, it contains no physical particles. Zero-point field is sometimes used as a synonym for the vacuum state of an individual quantized field.

According to present-day understanding of what is called the vacuum state or the quantum vacuum, it is “by no means a simple empty space”,[1] and again: “it is a mistake to think of any physical vacuum as some absolutely empty void.”[2] According to quantum mechanics, the vacuum state is not truly empty but instead contains fleeting electromagnetic waves and particles that pop into and out of existence.[3][4][5]”

As I said, Krauss’ nothing was nothing but mysterious energy. Watch how BJ7 now works to get out of this one. He simply cannot understand what he reads at some level of complexity, and especially at a scientific level. He can’t even take Krauss at his own word as to that complex meaning.

So you’re saying he was talking about no space whatsoever, right. In spite of everything he later said in interviews, as well as to Steve Novella. Rest your case by all means. It’s been dead since the beginning.

Yet, even after I specifically asked you for them, you have never provided any references.
But above I have referenced an interview done just a few days ago, where Krauss confirms everything I have said.

Below I’ve summarised the relevant bits of the interview for my own benefit:
You can have it for free:

What’s amazing to me is that we’re now at a point where we can plausibly argue that a universe full of stuff came from a very simple beginning, the simplest of all beginnings: nothing.

Interviewer:
Your book argues that physics has definitively demonstrated how something can come from nothing. Do you mean that physics has explained how particles can emerge from so-called empty space, or are you making a deeper claim?

I’m making a deeper claim, but at the same time I think you’re overstating what I argued. I don’t think I argued that physics has definitively shown how something could come from nothing; physics has shown how plausible physical mechanisms might cause this to happen…We don’t know how something can come from nothing, but we do know some plausible ways that it might…But I am certainly claiming a lot more than just that. That it’s possible to create particles from no particles is remarkable…The fact that “nothing,” namely empty space, is unstable is amazing. But I’ll be the first to say that empty space as I’m describing it isn’t necessarily nothing…and certainly I show that that kind of nothing ain’t nothing anymore.

Given what we know about quantum gravity, or what we presume about quantum gravity, we know you can create space from where there was no space. And so you’ve got a situation where there were no particles in space, but also there was no space. That’s a lot closer to “nothing.”

But of course then people say that’s not “nothing,” because you can create something from it. They ask, justifiably, where the laws come from. And the last part of the book argues that we’ve been driven to this notion—a notion that I don’t like—that the laws of physics themselves could be an environmental accident. On that theory, physics itself becomes an environmental science, and the laws of physics come into being when the universe comes into being. And to me that’s the last nail in the coffin for “nothingness.”

Interviewer:
” It sounds like you’re arguing that ‘nothing’ is really a quantum vacuum…”

That would be a legitimate argument if that were all I was arguing….When I talk about empty space, I am talking about a quantum vacuum, but when I’m talking about no space whatsoever, I don’t see how you can call it a quantum vacuum.It’s true that I’m applying the laws of quantum mechanics to it, but I’m applying it to nothing, to literally nothing. No space, no time, nothing.

There may have been meta-laws that created it, but how you can call that universe that didn’t exist “something” is beyond me. When you go to the level of creating space, you have to argue that if there was no space and no time, there wasn’t any pre-existing quantum vacuum…and of course then you’ll say that the laws of quantum mechanics existed, and that those are something. But I don’t know what laws existed then. In fact, most of the laws of nature didn’t exist before the universe was created; they were created along with the universe, at least in the multiverse picture.

when you apply quantum field theory to a dynamic universe, things change and you can go from one kind of vacuum to another. When you go from no particles to particles, it means something.

There are a variety of multiverses that people in physics talk about. The most convincing one derives from something called inflation, which we’re pretty certain happened because it produces effects that agree with almost everything we can observe. From what we know about particle physics, it seems quite likely that the universe underwent a period of exponential expansion early on. But inflation, insofar as we understand it, never ends—it only ends in certain regions and then those regions become a universe like ours. You can show that in an inflationary universe, you produce a multiverse, you produce an infinite number of causally separated universes over time, and the laws of physics are different in each one. There’s a real mechanism where you can calculate it.

And all of that comes, theoretically, from a very small region of space that becomes infinitely large over time. There’s a calculable multiverse; it’s almost required for inflation—it’s very hard to get around it. All the evidence suggests that our universe resulted from a period of inflation, and it’s strongly suggestive that well beyond our horizon there are other universes that are being created out of inflation, and that most of the multiverse is still expanding exponentially.

Right. How do you tell that there’s a multiverse if the rest of the universes are outside your causal horizon?…imagine that we had a fundamental particle theory that explained why there are three generations of fundamental particles, and why the proton is two thousand times heavier than the electron, and why there are four forces of nature, etc. And it also predicted a period of inflation in the early universe, and it predicts everything that we see and you can follow it through the entire evolution of the early universe to see how we got here. Such a theory might, in addition to predicting everything we see, also predict a host of universes that we don’t see. If we had such a theory, the accurate predictions it makes about what we can see would also make its predictions about what we can’t see extremely likely. And so I could see empirical evidence internal to this universe validating the existence of a multiverse, even if we could never see it directly.

“Your book argues that physics has definitively demonstrated how something can come from nothing. Do you mean that physics has explained how particles can emerge from so-called empty space, or are you making a deeper claim?

Krauss: I’m making a deeper claim, but at the same time I think you’re overstating what I argued. I don’t think I argued that physics has definitively shown how something could come from nothing; physics has shown how plausible physical mechanisms might cause this to happen. I try to be intellectually honest in everything that I write, especially about what we know and what we don’t know. If you’re writing for the public, the one thing you can’t do is overstate your claim, because people are going to believe you. They see I’m a physicist and so if I say that protons are little pink elephants, people might believe me. And so I try to be very careful and responsible. We don’t know how something can come from nothing, but we do know some plausible ways that it might.

But I am certainly claiming a lot more than just that. That it’s possible to create particles from no particles is remarkable—that you can do that with impunity, without violating the conservation of energy and all that, is a remarkable thing. The fact that “nothing,” namely empty space, is unstable is amazing. But I’ll be the first to say that empty space as I’m describing it isn’t necessarily nothing, although I will add that it was plenty good enough for Augustine and the people who wrote the Bible. For them an eternal empty void was the definition of nothing, and certainly I show that that kind of nothing ain’t nothing anymore ”

Caught you lying again, didn’t I?

“But I’ll be the first to say that empty space as I’m describing it isn’t necessarily nothing, although I will add that it was plenty good enough for Augustine and the people who wrote the Bible. For them an eternal empty void was the definition of nothing, and certainly I show that that kind of nothing ain’t nothing anymore ”

Not only wrong already, but lying about what Krauss really said in the interview. How low can you sink to avoid the simple admission that you were simply and completely wrong.

You insisted that he was talking only about quantum fluctuation type of nothingness.
I explained that he was also talking about at least two other types of nothingness – his “deeper claim” (quantum gravity and multiverse/inflation).

So now that you have admitted that he was actually talking about more than quantum fluctuation type of nothingness, the argument is surely over.

Progress at last!

But, of course it hasn’t been proven, you idiot!
It’s consistent with theory.
Welcome to the world of science!

And read the whole damn article.
Well here’s Krauss again:

“Right. How do you tell that there’s a multiverse if the rest of the universes are outside your causal horizon?…imagine that we had a fundamental particle theory that explained why there are three generations of fundamental particles, and why the proton is two thousand times heavier than the electron, and why there are four forces of nature, etc. And it also predicted a period of inflation in the early universe, and it predicts everything that we see and you can follow it through the entire evolution of the early universe to see how we got here. Such a theory might, in addition to predicting everything we see, also predict a host of universes that we don’t see. If we had such a theory, the accurate predictions it makes about what we can see would also make its predictions about what we can’t see extremely likely. And so I could see empirical evidence internal to this universe validating the existence of a multiverse, even if we could never see it directly. “

“…if your definition of “nothing” is “emptiness” or “lack of space itself,” the laws of quantum mechanics provide a nice way to understand how that nothing can evolve into the marvelous something we find ourselves inside. This is interesting, and important, and worth writing a book about, and it’s one of the possibilities Lawrence discusses.”

Got that?
Nothing as “empty space” OR “lack of space itself”, not just “empty space” as you insisted.

” In this kind of picture [creation of the universe form nothing], there is literally a moment in the history of the universe prior to which there weren’t any other moments. There is a boundary of time (presumably at the Big Bang), prior to which there was … nothing. No stuff, not even a quantum wave function; there was no prior thing, because there is no sensible notion of “prior.” This is also interesting, and important, and worth writing a book about, and it’s another one of the possibilities Lawrence discusses.”

You are simply a liar. You deliberately removed the section of the interview where Krauss said what he really meant, which was what Steven Novella also said he meant. Now you are bringing in a different physicist to claim you didn’t deliberately misquote Krauss? You misquoted Krauss. You lied about what you knew he said.
Any real scientist would be licked out of the lab he worked in, research papers would all be questioned, jobs would dry up for him, etc., etc. You are a flat out liar and always have been.
Others have called you out on lying and I’m calling you out right now. You’re a proven liar.
Any other science blog would ban you for this kind of posting. That’s probably why you’re only posting here. You’re a pathological liar and wouldn’t be tolerated elsewhere.
I suspect you HAVE been ousted from some other venues but that’s no longer at issue. What’s a proven fact is that you’ve just committed an unpardonable sin in science, and can no longer be trusted to present the facts as you actually know them in any scientific argument, or any other kind of argument for that matter.
You’re a liar and this time I caught you in a whopper.

I provided the link so you could read the whole article and I provided a summary in case you didn’t want to read the whole thing. What more can I do. Both the summary and the whole article support what I have always said is in the book.

I suggest that you actually read the book.

But, as I have always said, you cannot understand what you read and then just make things up about what you think you read based on preconceived ideas on the subject, so I’m not sure reading the book will make any difference.

There is really not much else I can do for you to help you understand.

Note, folks, how he’s lied again. He claims he ‘summarized’ the article that he had previously cited, except that he had cited a Scientific American article and falsified the contents of an entirely different Atlantic article. Deftly removing the conclusions in the bargain. Caught in a lie doesn’t seem to phase him at all. Watch him lie again.

Ha! That is funny. You are suffering from a massive delusion that someone else in the universe is bothering to follow your debate with BJ. BJ seems to suffer from the same delusion. As I suggested before, I actually think both of you are just one person. So Dr Novella was right. Mental illness does exist and you are the first case.

You delude again. As soon as I see the letters c w f o n g in any comment my 53 neurons immediately go into absolute shut down mode. If that makes me nutty then that only proves that approximately 0.999999999999999999999% of the world’s population is insane. Hence the popular saying… ‘there’s always one isn’t there?’

Then why are you responding, you silly useless twit? Although you’ve done more to discredit that idiot Szasz that you follow than Dr. Novella’s post would have ever done. You and that other pathological pea brain liar make a good pair. Nobody will ever take either of you seriously again. You can project that sentiment back to me, but I present good papers to read at least, and you two have nothing.

Your ideas are ‘cut and paste’. You may think you can fool people but I can see through you just like Newton looked through a prism. Nice try. But tough cookie. Now just go away. Troll another blog where the level of your intellect will not be so transparent.

Firstly you didn’t do what you were told on my ‘special’ thread. 😉 Secondly, the enemy of my enemy is also my enemy. Which is why I am such a lonely old cantankerous git. Some call it brain damage cos I don’t even mind.

“The DSM has attracted praise for standardizing psychiatric diagnostic categories and criteria. It has also attracted controversy and criticism. Some critics argue that the DSM represents an unscientific system that enshrines the opinions of a few powerful psychiatrists. There are ongoing issues concerning the validity and reliability of the diagnostic categories; the reliance on superficial symptoms; the use of artificial dividing lines between categories and from ‘normality’; possible cultural bias; medicalization of human distress and financial conflicts of interest, including with the practice of psychiatrists and with the pharmaceutical industry; political controversies about the inclusion or exclusion of diagnoses from the manual, in general or in regard to specific issues; and the experience of those who are most directly affected by the manual by being diagnosed, including the consumer/survivor movement. The publication of the DSM, with tightly guarded copyrights, now makes APA over $5 million a year, historically adding up to over $100 million.”

Dr. N: “Psychiatry still deals with brain disorders, but focuses on those that primarily manifest as disorders of mood, thought, and behavior. These are not fundamentally different from brain disorders that manifest as abnormal movements, pain, language or cognitive problems”

They ARE fundamentally different.

there is a fundamental mistake here in assuming that “thoughts” that a psychiatrist might consider “ill” can be changed or reversed through drugs, shock or surgery. These therapies may elevate the mood of a depressed person, or calm a manic person, or wipe out the memories that may be contributing to any particular mood, but they do not change thought. They may even help to create a mental state that might be more receptive to changing thoughts, but they do not change thought.

Thoughts only change through interaction with information that changes them. This isn’t something simple, and it is scientific, but it’s not harmful or stigmatizing.

You are making a philosophical leap to say that mood, thought and behavioral disorders are brain disorders. If I make a mistake about a fact because i don’t have good information, is there something physically wrong with my brain? There are myriad causes of abnormal behavior that have nothing to do with the physical brain, and are instead a result of “abnormal” experience (experience gives information).

This all comes back to the nonsensical statement: the mind is what the brain does. Can you make this statement make sense? No, you can’t, because you do not wish the mind to be anything other than the brain. My experience of a certain brain state is not the same as the brain state. I think there is perhaps a failure to conceptualize this dilemma, and to instead simply deny its existence.

My comment above:
“It seems that the “improvements” in psychiatric care during the last 20-30 years have been mostly instigated by ex-patients and concerned humanitarians.”

you can investigate this for yourself by following the link and reading online about the history of improvements in psychiatric care. It does correspond to the development of new drugs, but is not necessarily the same improvement.

‘You are making a philosophical leap to say that mood, thought and behavioral disorders are brain disorders. If I make a mistake about a fact because i don’t have good information, is there something physically wrong with my brain? There are myriad causes of abnormal behavior that have nothing to do with the physical brain, and are instead a result of “abnormal” experience (experience gives information).’

‘With ADHD, part of that lack of ability is the ability to adapt and thrive to the typical school environment.’

Can you not see that this is a cultural problem which has nothing to do with science.

@BiilyJoe7
@cwfong

Many years ago in the deep dales of Sussex, England, where I reside, I had the privilege of taking afternoon tea, accompanied with cream and raspberry jam (jelly) scones and a genius by the name of the late W. D. Hamilton. Dear Bill… Richard Dawkins claim to fame has only been by standing on your shoulders… In comparison, James Shapiro is and will always be a monkey.

‘When we are talking about mental illness we are therefore talking about a brain disorder. ‘

An assumption. What happened to the ‘mental illnesses’ known as drapetomania, masturbatory insanity, hysteria, homosexuality?

Today we have Multiple Personality Disorder, (a scientific joke!) or Oppositional Defiance Disorder. (Even George Orwell could not imagine this!). There is no objective scientific observation that is made to ‘diagnose’ even one of the 300 odd mental disorders defined in the DSM. Not one.

As Tom Insel, Director of the National Institute of Mental Health (NIMH), has stated, “We don’t talk much about this,” he said, but when it comes to mental illnesses, psychiatrists lag far behind their colleagues in other specialties. “Diagnosis is by observation, detection is late, prediction is poor. Etiology is unknown, prevention is undeveloped. Therapy is by trial-and-error. We have no cures, no vaccines. We’re not even working on vaccines. Prevalence has not decreased. Mortality has not decreased.”

There has been no progress in psychiatry since Kraeplin defined the 3 ‘mental diseases’. It is the same as if I went to the doctor complaining of chest pains and told take this morphine… you will feel better. It is a pseudoscience. A total sCAM.

So first question. Do you think that Multiple Personality Disorder is a scientifically proven brain disease? The fact that an individual can have totally separate ‘personalities’ that have no knowledge of each others existence and that can range from an 11 year old girl to an grumpy old man… you think this is scientific or a fantasy?

Tom Insel, Director of the National Institute of Mental Health (NIMH), has stated, “We don’t talk much about this,” he said, but when it comes to mental illnesses, psychiatrists lag far behind their colleagues in other specialties. “Diagnosis is by observation, detection is late, prediction is poor. Etiology is unknown, prevention is undeveloped. Therapy is by trial-and-error. We have no cures, no vaccines. We’re not even working on vaccines. Prevalence has not decreased. Mortality has not decreased.”

I’m not aware that MPD is presently recognized as a brain disease. In any case, I’m not going to go down the complete list of questionable definitions in the DSM with you.
However, I have given lectures to psychiatric interns regarding the typical behaviors of sociopaths, and my take on the causative factors involved including the various “other than normal” unconscious behavior patterns that we think we see. Nobody knows for certain whether or where sociopaths have crossed the the theoretical line from normal to defective, as sociopaths don’t ordinarily seek treatment, and especially those who are extraordinarily successful. Criminal sociopaths are of course examined in prison, but not usually for treatment purposes either. Yet if this is a condition that leads to a much larger percentage of criminal behavior than would occur in its absence, is it wrong to classify it as an Antisocial Personality Disorder?

I don’t want to discuss that old charlatan Bob Hare’s pseudoscience either. It is just another Forer effect fraud. A sociopath has a brain disease? Humbug! Game theory, and the prisoner’s dilemma explain the sociopath strategy adequately for me. The term “Antisocial Personality” Disorder betrays the cultural significance of the term – it has nothing to do with science at all.

Brain disease? Some psychopaths are made and some are born. Calling the disorder (or disorders in general) a disease seems to be the only card you have up your sleeve. Of course there is a cultural significance to every term, and especially to those where science as the more reliable discerning method attempts to deal with cultural phenomena. The DSM is one huge categorical arrangement of culturally designated mistakes. Get used to it.

Popper, isn’t he the one that insisted on the falsification principle? That the core element of a scientific hypothesis is that it must have the capability of being proven false? Tell that to Einstein.

I asked you loads of questions earlier which you never responded to. Is this because the questions are not worth asking? I am trying to learn here. I am just a geezer down the pub. I come here to learn. I try to ask the most polarised difficult questions in order to receive the best answers. I am happy to be proved wrong. Most of the time I am wrong. I have no axe to grind either way. You seem to evade everything.

AHH well the original sense of “bonkers,” which first appeared in the early 20th century, was “light-headed, giddy” or “slightly drunk,” and it may have originated in the British navy. The “insane” sense apparently only arose after World War II, but is the standard usage now. “Bonkers” is often coupled with intensifying words depending on the severity of the affliction — a person adjudged “raving bonkers” or “stark staring bonkers” is not someone you want to sit next to on the subway.

I don’t take the subway. My driver Jeeves will alleviate this problem.

I see you have read my book and successfully implemented, ‘Trolling using Mental Illness as an excuse,’ using the fourth strategy, detailed from page 207. Well done for your successful trolling (as detailed in my latest Book. Available at all sophisticated book retailers for a price Discounts avaiable for wholesale..) Well done!

‘And beyond this, a diagnostic system without objective tests is vulnerable to arbitrary changes that can do more harm than good. The furor over the draft of the upcoming edition of psychiatry’s diagnostic bible, the DSM-5, is caused by its radical expansion of the boundaries of psychiatry that will increase by tens of millions the number of people presumed to be suffering from mental disorders. This would be done based on fallible committee decisions, unsupported by solid scientific understanding. ‘

‘The history of Morgellons is relevant as well. The term and the belief that this is a distinct entity did not derive from the observations of physicians or scientists, or any study or new knowledge about biology. It was invented..’

‘that the existence of a subculture that promotes the notion of a biological rather than psychological disorder invests sufferers in this conclusion, makes them hostile to a psychological diagnosis’

This is ‘Szaszian’ thinking. It is true of ALL psychiatric ‘mental disorders’. From schizophrenia to ADHD! How do you square your logical thinking?

Scientists are very easily deceived. They think logically, extrapolate possibilities from evidence presented, assume (with a good probability of being right) certain aspects of the observed data and draw upon their past experience in coming to decisions. This is to say that they act very much as all humans do, struggling with sensory input to derive new facts from it. But scientists do this with a certain authority and certainty born of their training and discipline. They are thus excellent candidates for being flimflammed by a clever operator who is aware of the fact that scientists seldom bring the ‘Human’ element into account.

Psychiatry is an insiduous pseudo science because it utilises the metaphors of language that are generally unconscious to our analytical mind. In the same way that we all use and ‘understand’ grammar until we are asked to explain it. Can you tell me the difference between the pluperfect tense and the present perfect? (hey! don’t wiki it first…)

You dickface. I received by Ph.D from my research into the similarities between the iambic pentameter used by Shakespeare in his magnificent plays and the obsession with the pentatonic scale as expressed by the greatet blues players, like this

I’m a rolling stone, all alone and lost,
For a life of sin, I have paid the cost.
When I pass by, all the people say
“Just another guy on the lost highway.”

Just a deck of cards and a jug of wine
And a woman’s lies make a life like mine.
Oh, the day we met, I went astray,
I started rollin’ down that lost highway.

‘And beyond this, a diagnostic system without objective tests is vulnerable to arbitrary changes that can do more harm than good. The furor over the draft of the upcoming edition of psychiatry’s diagnostic bible, the DSM-5, is caused by its radical expansion of the boundaries of psychiatry that will increase by tens of millions the number of people presumed to be suffering from mental disorders. This would be done based on fallible committee decisions, unsupported by solid scientific understanding. Seemingly small and weakly supported changes in the definition of mental disorders can have huge real world impacts, often with extremely harmful unintended consequences.’